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Shi C, Ju H, Zhou R, Xu S, Wu Y, Gu Z, Wang Y, Chen W, Huang X, Han Y, Sun S, Li C, Wang M, Zhou G, Zhang Z, Li J, Ren G. The efficacy and safety of dalpiciclib, a cyclin-dependent kinase 4/6 inhibitor, in patients with advanced head and neck mucosal melanoma harboring CDK4 amplification. BMC Med 2024; 22:215. [PMID: 38807144 PMCID: PMC11134887 DOI: 10.1186/s12916-024-03431-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 05/20/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Mucosal melanoma (MM) is a rare but devastating subtype of melanoma. Our previous studies have demonstrated robust anti-tumor effects of cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors in head and neck MM (HNMM) patient-derived xenograft models with CDK4 amplification. Herein, we aimed to investigate the efficacy and safety of dalpiciclib (SHR6390), a CDK4/6 inhibitor, in HNMM patients harboring CDK4 amplification. METHODS The anti-tumor efficacy of dalpiciclib was assessed by HNMM patient-derived xenograft (PDX) models and patient-derived tumor cells (PDC) in vivo and in vitro. Immunohistochemical analyses and western blot were then performed to assess the markers of cell proliferation and CDK4/6 signaling pathway. For the clinical trial, advanced recurrent and/or metastatic HNMM patients with CDK4 amplification were treated with dalpiciclib 125 mg once daily for 21 consecutive days in 28-day cycles. The primary endpoint was disease control rate (DCR). Secondary endpoints included safety, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). RESULTS Dalpiciclib profoundly suppressed growth of HNMM-PDX and PDC with CDK4 amplification, whereas it showed relatively weak suppression in those with CDK4 wild type compared with vehicle. And dalpiciclib resulted in a remarkable reduction in the expression levels of Ki-67 and phosphorylated Rb compared with control group. In the clinical trial, a total of 17 patients were enrolled, and 16 patients were evaluable. The ORR was 6.3%, and the DCR was 81.3%. The estimated median PFS was 9.9 months (95% CI, 4.8-NA), and the median OS was not reached. The rate of OS at 12 months and 24 months was 68.8% (95% CI, 0.494-0.957) and 51.6% (95% CI, 0.307-0.866), respectively. The most frequent adverse events were neutrophil count decrease, white blood cell count decrease, and fatigue. CONCLUSIONS Dalpiciclib was well-tolerated and displayed a durable benefit for HNMM patients with CDK4 amplification in this study. Further studies on CDK4 inhibitors and its combination strategy for MM are worth further exploration. TRIAL REGISTRATION ChiCTR2000031608.
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Affiliation(s)
- Chaoji Shi
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, 200011, People's Republic of China
| | - Houyu Ju
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Rong Zhou
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Shengming Xu
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Yunteng Wu
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Ziyue Gu
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Ying Wang
- Clinical Research & Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, 200011, People's Republic of China
| | - Wanling Chen
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Xinyi Huang
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Yong Han
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Shuyang Sun
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Chuwen Li
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Min Wang
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
- Department of Oral Pathology, School of Medicine, Ninth People's Hospital, Shanghai Jiao Tong University, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
| | - Guoyu Zhou
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Zhiyuan Zhang
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China.
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China.
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China.
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, 200011, People's Republic of China.
| | - Jiang Li
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China.
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China.
- Department of Oral Pathology, School of Medicine, Ninth People's Hospital, Shanghai Jiao Tong University, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China.
| | - Guoxin Ren
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China.
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China.
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China.
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Uchi H. Optimal strategy in managing advanced melanoma. J Dermatol 2024; 51:324-334. [PMID: 38087810 DOI: 10.1111/1346-8138.17068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/01/2023] [Accepted: 11/20/2023] [Indexed: 03/05/2024]
Abstract
The advent of immune checkpoint inhibitors and combination therapy with BRAF inhibitors and MEK inhibitors has dramatically improved the prognosis of advanced melanoma. However, since acral melanoma and mucosal melanoma, which are rare in Western countries but are major subtypes of melanoma in East Asia, including Japan, have a low frequency of BRAF mutations, there are currently no treatment options other than immune checkpoint inhibitors in most such cases. Furthermore, owing to a lower tumor mutation burden, immune checkpoint inhibitors are less effective in acral and mucosal melanoma than in cutaneous melanoma. The aim of this review was to summarize the current status and future prospects for the treatment of advanced melanoma, comparing cutaneous melanoma, acral melanoma, and mucosal melanoma.
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Affiliation(s)
- Hiroshi Uchi
- Department of Dermato-Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
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Riazi-Esfahani H, Amini A, Masoomian B, Yaseri M, Sabour S, Rashidinia A, Arjmand M, Rafizadeh SM, Johari M, Khalili Pour E, Ghassemi F. Uveal melanoma in the Iranian population: two decades of patient management in a tertiary eye center. Int J Retina Vitreous 2024; 10:25. [PMID: 38429783 PMCID: PMC10905845 DOI: 10.1186/s40942-024-00531-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 01/17/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND To assess the characteristics and outcomes of uveal melanoma management at a tertiary center in the Middle East. METHODS A study on 164 patients with uveal melanoma was conducted by reviewing the available medical records, ultrasound, and pathology report results. Age at diagnosis, tumor location and size, treatment mode, visual outcome, metastasis, mortality, and survival were studied. RESULTS The mean age of patients was 52.0 ± 15.0 years, and 52.5% were male. Choroidal melanoma was the most common uveal melanoma, followed by the ciliary body and iris melanoma. The mean thickness of tumors was 8.29 ± 3.29. The majority of patients (n = 111, 67.9%) were managed by brachytherapy with ruthenium-106 plaques. Enucleation was performed primarily in 46 (28%) patients and secondarily in nine (5.5%) patients. The sexual disparity was detected as the proximity of uveal melanoma to the fovea in males. For a 61-month mean follow-up period, mortality occurred in eight of our cases, six of which were due to metastasis. The most common site for distance metastasis was the liver (5/6), followed by the lung (1/6). The five-year and eight-year overall survival (OS) rate was 0.947%± 0.019. The 5-year survival rate reached zero in metastatic patients. OS was not statistically different depending on the age, tumor diameters, the primary treatment received, or the histopathologic findings (p > 0.50 for all). CONCLUSION In this study, individuals diagnosed with UM exhibited an OS rate of around 94% at the five-year mark, which remained consistent up to eight years. Notably, the presence of distance metastasis emerged as the sole statistically significant factor influencing overall survival.
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Affiliation(s)
- Hamid Riazi-Esfahani
- Ocular Oncology Service, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdulrahim Amini
- Department of Ophthalmology, School of Medicine, Hormozgan University of medical sciences, Bandar Abbas, Iran
| | - Babak Masoomian
- Ocular Oncology Service, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Sabour
- Department of Clinical Epidemiology, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Rashidinia
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Arjmand
- Ocular Oncology Service, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
| | - Seyed Mohsen Rafizadeh
- Orbital and Oculoplastics Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadkarim Johari
- Department of Ophthalmology, Poostchi Ophthalmology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elias Khalili Pour
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Ghassemi
- Ocular Oncology Service, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran.
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Shen A, Arbesman M, Lodha R, Rayman P, Bungo B, Ni Y, Chan T, Gastman B, Ko J, Diaz-Montero CM, Arbesman J, Funchain P. Clinical and Immunologic Features of Germline Pathogenic Variant-Positive Patients with Melanoma. Clin Cancer Res 2024; 30:564-574. [PMID: 38032355 DOI: 10.1158/1078-0432.ccr-23-1964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/07/2023] [Accepted: 11/28/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Malignant melanoma represents the most lethal skin cancer with germline predispositions thought to comprise 10% to 15% of all melanoma cases. No studies to date examine the immunologic features that may differentiate survival differences between germline pathogenic variant (gPV)-positive patients with melanoma from gPV-negative patients with melanoma. EXPERIMENTAL DESIGN Adult patients with melanoma and clinical characteristics suggesting hereditary predisposition to cancer were prospectively recruited to undergo germline testing and flow cytometric analysis of peripheral immune suppressor cells. RESULTS In this cohort, gPV-positive patients (n = 72) had a significantly improved melanoma-specific survival (MSS) compared with gPV-negative patients (n = 411; HRadj, 0.32; 95% CI, 0.13-0.82; P = 0.01). These survival improvements among gPV-positive patients were most apparent among cutaneous melanoma subtypes (HRadj, 0.12; 95% CI, 0.016-0.86; P = 0.03) and numerically improved in later-stage (IIB-IV) patients (HRadj, 0.34; 95% CI, 0.10-1.11; P = 0.06). Further, gPV-positive patients had a significantly lower level of total circulating PMN-MDSC compared with gPV-negative patients (P = 0.01), which was most apparent in those diagnosed with later stages (IIB-IV) of melanoma (P = 0.009). Finally, a significant upregulation of inflammatory transcriptome signatures in later-stage gPV-positive patients (n = 21) was observed in comparison with gPV-negative patients (n = 173) in the cutaneous melanoma cohort (SKCM) of The Cancer Genome Atlas (TCGA). CONCLUSIONS gPV-positive patients with melanoma exhibit improved MSS in addition to reduced peripheral PMN-MDSC and an enhanced inflammatory microenvironment.
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Affiliation(s)
- Alan Shen
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | | | - Roshan Lodha
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Patricia Rayman
- Cleveland Clinic Immuno-monitoring Laboratory, Cleveland, Ohio
| | - Brandon Bungo
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Ying Ni
- Cleveland Clinic Center for Precision Immunotherapy, Cleveland, Ohio
| | - Timothy Chan
- Cleveland Clinic Center for Precision Immunotherapy, Cleveland, Ohio
| | - Brian Gastman
- Cleveland Clinic Center for Precision Immunotherapy, Cleveland, Ohio
- Cleveland Clinic Department of Dermatology and Plastic Surgery, Cleveland, Ohio
| | - Jennifer Ko
- Cleveland Clinic Immuno-monitoring Laboratory, Cleveland, Ohio
- Cleveland Clinic Center for Precision Immunotherapy, Cleveland, Ohio
- Cleveland Clinic Department of Dermatology and Plastic Surgery, Cleveland, Ohio
| | - C Marcela Diaz-Montero
- Cleveland Clinic Immuno-monitoring Laboratory, Cleveland, Ohio
- Cleveland Clinic Center for Precision Immunotherapy, Cleveland, Ohio
| | - Joshua Arbesman
- Cleveland Clinic Department of Dermatology and Plastic Surgery, Cleveland, Ohio
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Huang C, Lau TWS, Smoller BR. Diagnosing Cutaneous Melanocytic Tumors in the Molecular Era: Updates and Review of Literature. Dermatopathology (Basel) 2024; 11:26-51. [PMID: 38247727 PMCID: PMC10801542 DOI: 10.3390/dermatopathology11010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Over the past decade, molecular and genomic discoveries have experienced unprecedented growth, fundamentally reshaping our comprehension of melanocytic tumors. This review comprises three main sections. The first part gives an overview of the current genomic landscape of cutaneous melanocytic tumors. The second part provides an update on the associated molecular tests and immunohistochemical stains that are helpful for diagnostic purposes. The third section briefly outlines the diverse molecular pathways now utilized for the classification of cutaneous melanomas. The primary goal of this review is to provide a succinct overview of the molecular pathways involved in melanocytic tumors and demonstrate their practical integration into the realm of diagnostic aids. As the molecular and genomic knowledge base continues to expand, this review hopes to serve as a valuable resource for healthcare professionals, offering insight into the evolving molecular landscape of cutaneous melanocytic tumors and its implications for patient care.
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Affiliation(s)
- Chelsea Huang
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | | | - Bruce R. Smoller
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA;
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Shi X, Shi J, Li Y, Li X, Hu X, Gao H. Primary Malignant Melanoma of the Endometrium: A Case Report. Case Rep Oncol 2024; 17:370-376. [PMID: 38415269 PMCID: PMC10898855 DOI: 10.1159/000535635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/22/2023] [Indexed: 02/29/2024] Open
Abstract
Introduction Malignant melanoma most commonly occurs in the skin. Primary malignant melanoma of endometrium is quite rare. Its diagnosis depends on clinical characteristics and pathological examination. It usually exhibits high degree of tumor histology, early onset of distant metastases, and unfavorable prognoses. Case Presentation In this paper, we report a case of a 73-year-old woman with primary malignant melanoma of endometrium. This patient denied a history of nevus removal or any family medical history of cancer. She was admitted to the hospital for irregular vaginal bleeding after menopause and performed an endometrial biopsy. Pathological of the scrapings suggested malignant melanoma. She subsequently underwent a radical surgery. The final pathology diagnosis was primary malignant melanoma of endometrium, and BRAF gene mutation was detected. The tumor staged as IVB according to the International Federation of Gynecology and Obstetrics (FIGO) classification. Thus, she then started adjuvant chemotherapy. This patient is currently on oral targeted therapy and is still being followed up. Conclusion Mucosal melanoma is infrequent, and primary malignant melanoma of endometrial is a rare subtype. To the best of our knowledge, malignant melanoma originating from endometrium has never been reported before. It has a high degree of malignancy and is prone to early metastasis. Further investigations are warranted to explore its underlying pathogenesis, management, and outcomes.
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Affiliation(s)
- Xiuting Shi
- Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Jie Shi
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanli Li
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Li
- Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Xuemei Hu
- Medical College, Hubei University of Medicine, Shiyan, China
| | - Han Gao
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Nomura M. Definitive treatment for head and neck mucosal melanoma. Jpn J Clin Oncol 2023; 53:1112-1118. [PMID: 37609679 DOI: 10.1093/jjco/hyad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
Head and neck mucosal melanoma is a rare clinical subtype of melanoma or head and neck cancer. Mucosal melanoma is aetiologically and molecularly distinct from cutaneous melanoma. The therapeutic efficacy of immune checkpoint inhibitors for head and neck mucosal melanoma remains unclear. Surgery is considered as the mainstay of treatment for locally advanced head and neck mucosal melanoma, and adjuvant radiotherapy has a role in local disease control. New treatment modalities, such as targeted therapy and immunotherapy, have changed the treatment of cutaneous melanoma. However, patients with mucosal melanoma have been excluded from most Phase III clinical trials. Due to its rarity, outcome data for locally advanced head and neck mucosal melanoma are scarce and are mainly based on retrospective studies with limited case numbers. The objective of this review was to provide an update and overview of clinical trials, prospective observational studies and retrospective studies and discuss future directions for multimodal treatment of locally advanced head and neck mucosal melanoma.
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Affiliation(s)
- Motoo Nomura
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
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8
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Sun W, Liu K, Zhou H, Zhao F, Dong Y, Xu Y, Kong Y, Wang M, Cheng X, Chen Y. Whole-exome sequencing reveals mutational profiles of anorectal and gynecological melanoma. Med Oncol 2023; 40:330. [PMID: 37831226 PMCID: PMC10575813 DOI: 10.1007/s12032-023-02192-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023]
Abstract
Mucosal melanoma is a rare and highly malignant type of melanoma. Among the sites that mucosal melanoma arises, anorectal and gynecological melanoma has more aggressive behavior and worse prognosis. There was no effective therapy for mucosal melanoma at present. Only a small number of mucosal melanoma patients which harbor mutations in BRAF or KIT benefit from targeted therapy. So it's an urgent need to identify more actionable mutations in mucosal melanoma. To identify more potential therapeutic targets in mucosal melanoma, 48 samples were collected from 44 patients with anorectal or gynecological melanoma and subjected to whole-exome sequencing. The tumor mutation burden was low with a median of 1.75 mutations per Mb. In chromosomal level, 1q, 6p and 8q of mucosal melanoma were significantly amplified while 9p, 10p, 10q, 16p and 16q were significantly deleted. Muc16 was the most frequently mutated oncogene in our samples(25%). The mutation frequency of KIT(20%) was comparable to the "triple-wild" genes-NRAS(20%), NF1(20%), and BRAF(11%). KMT2D mutation was found in 18.18% patients, which is previously unidentified. MAPK signaling pathway and lysine degradation were the most frequently mutated pathways. Moreover, patients with TP53 mutations tend to have worse clinical outcome (median survival time 19 vs. 50 months, log-rank P = 0.006). 2000 ore mutated genes involved in MAPK signaling pathway were identified, which expand the patients potentially benefit from ample MAPK inhibitors. KMT2D could be a potential therapeutic target. Moreover, TP53 could be a potential prognosis marker for mucosal melanoma.
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Affiliation(s)
- Wei Sun
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Kunyan Liu
- Department of Bioinformatics, School of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Hongyu Zhou
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Gynecological Oncology, Minhang Branch of Fudan University Shanghai Cancer Center, Shanghai, China
| | - Fang Zhao
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - Yan Dong
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China
| | - Yu Xu
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yunyi Kong
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Minghe Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xi Cheng
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Gynecological Oncology, Minhang Branch of Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yong Chen
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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Morra S, Incesu RB, Scheipner L, Baudo A, Jannello LMI, de Angelis M, Siech C, Goyal JA, Tian Z, Saad F, Califano G, la Rocca R, Capece M, Shariat SF, Ahyai S, Carmignani L, de Cobelli O, Musi G, Tilki D, Briganti A, Chun FKH, Longo N, Karakiewicz PI. Demographics, Clinical Characteristics and Survival Outcomes of Primary Urinary Tract Malignant Melanoma Patients: A Population-Based Analysis. Cancers (Basel) 2023; 15:4498. [PMID: 37760467 PMCID: PMC10527544 DOI: 10.3390/cancers15184498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/28/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
All primary urinary tract malignant melanoma (ureter vs. bladder vs. urethra) patients were identified from within the Surveillance, Epidemiology, and End Results (SEER) database 2000-2020. Kaplan-Maier plots depicted the overall survival (OS) rates. Univariable and multivariable Cox regression (MCR) models were fitted to test the differences in overall mortality (OM). In the overall cohort (n = 74), the median OS was 22 months. No statistically significant or clinically meaningful differences were recorded according to sex (female vs. male; p = 0.9) and treatment of the primary (endoscopic vs. surgical; p = 0.6). Conversely, clinically meaningful but not statistically significant (p ≥ 0.05) differences were recorded according to the patient's age at diagnosis (≤80 vs. ≥80 years old; p = 0.2), marital status (married 26 vs. unmarried 16 months; p = 0.2), and SEER stage (localized 31 vs. regional 14 months; p = 0.4), and the type of systemic therapy (exposed 31 vs. not exposed 20 months; p = 0.06). Finally, in univariable and MCR analyses, after adjustment for the SEER stage and type of systemic therapy, tumor origin within the bladder was associated with a three-fold higher OM (Hazard ratio: 3.00; p = 0.004), compared to tumor origin within the urethra. In conclusion, primary urinary tract malignant melanoma patients have poor survival. Specifically, tumor origin within the bladder independently predicted a higher OM, even after adjustment for the SEER stage and systemic therapy status.
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Affiliation(s)
- Simone Morra
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Reha-Baris Incesu
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Lukas Scheipner
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Urology, Medical University of Graz, 8036 Graz, Austria;
| | - Andrea Baudo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Urology, IRCCS Policlinico San Donato, 20097 Milan, Italy;
| | - Letizia Maria Ippolita Jannello
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (O.d.C.); (G.M.)
- Università degli Studi di Milano, 20126 Milan, Italy
| | - Mario de Angelis
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Division of Experimental Oncology, Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Carolin Siech
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 39120 Frankfurt am Main, Germany;
| | - Jordan A. Goyal
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
| | - Gianluigi Califano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Roberto la Rocca
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Marco Capece
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Shahrokh F. Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria;
- Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Hourani Center of Applied Scientific Research, Al-Ahliyya Amman University, Amman 19328, Jordan
| | - Sascha Ahyai
- Department of Urology, Medical University of Graz, 8036 Graz, Austria;
| | - Luca Carmignani
- Department of Urology, IRCCS Policlinico San Donato, 20097 Milan, Italy;
- Department of Urology, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (O.d.C.); (G.M.)
- Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy
| | - Gennaro Musi
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy; (O.d.C.); (G.M.)
- Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
- Department of Urology, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Urology, Koc University Hospital, 34010 Istanbul, Turkey
| | - Alberto Briganti
- Division of Experimental Oncology, Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Felix K. H. Chun
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 39120 Frankfurt am Main, Germany;
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (G.C.); (R.l.R.); (M.C.); (N.L.)
| | - Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (R.-B.I.); (L.S.); (A.B.); (L.M.I.J.); (M.d.A.); (C.S.); (J.A.G.); (Z.T.); (F.S.); (P.I.K.)
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10
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Nguyen Q, Nguyen HT, Bui XT, Bui VQ, Nguyen TD. Primary malignant melanoma of the male urethra: Case report and review of literature. Int J Surg Case Rep 2023; 110:108697. [PMID: 37611396 PMCID: PMC10470298 DOI: 10.1016/j.ijscr.2023.108697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023] Open
Abstract
INTRODUCTION We report a rare case of primary malignant melanoma with inguinal lymph node metastasis in the male urethra. CASE PRESENTATION A 57-year-old male patient presented with a small tumor on the ventral surface of the penis, which was discovered 5 months ago and did not cause pain or discomfort. In the past month, the patient has developed symptoms of urinary incontinence. MRI and PET/CT scans revealed a primary tumor in the penile urethra, but no metastases were found. The patient underwent partial penectomy surgery and laparoscopic bilateral inguinal lymphadenectomy within one month. The pathological combined with immunohistochemical staining confirmed primary malignant melanoma in the urethra with right inguinal lymph node metastasis. Despite complying with surgical and immunotherapy treatment with Pembrolizumab for 18 cycles, the patient was diagnosed with recurrent cancer in the penile stump after 05 months and he passed away after 18 months. DISCUSSION Urethral melanoma is a rare and highly invasive type of cancer. It was often diagnosed at a late stage because the initial symptoms were not obvious in the lower urinary tract. Additionally, cancer progressed very quickly, making it difficult to treat. CONCLUSION Urethral melanoma, if detected at a late stage with lymph node metastasis, has a significantly poor prognosis irrespective of the treatment method employed. However, to our best knowledge, very few publications can be found on this disease, and the strategic treatment remained unknown.
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Affiliation(s)
- Quang Nguyen
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Viet Nam; University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam.
| | - Huu Thao Nguyen
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Viet Nam
| | - Xuan Truong Bui
- Department of Surgery, Hanoi Medical Univerity, Hanoi, Viet Nam
| | - Van Quang Bui
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Viet Nam; University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
| | - Tien Dung Nguyen
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Viet Nam; University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
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11
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Wang HY, Liu Y, Deng L, Jiang K, Yang XH, Wu XY, Guo KH, Wang F. Clinical significance of genetic profiling based on different anatomic sites in patients with mucosal melanoma who received or did not receive immune checkpoint inhibitors. Cancer Cell Int 2023; 23:187. [PMID: 37649078 PMCID: PMC10469937 DOI: 10.1186/s12935-023-03032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/15/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND To date, data on the efficacy of targeted therapies for mucosal melanoma (MM) are limited. In this study, we analyzed genetic alterations according to the primary site of origin, which could provide clues for targeted therapy for MM. METHODS We conducted a retrospective cohort study of 112 patients with MM. Targeted sequencing was performed to analyze genetic aberrations. Kaplan-Meier analysis was conducted with the log-rank test to compare the significance among subgroups. RESULTS In total, 112 patients with MM were included according to the anatomic sites: 38 (33.9%) in the head and neck, 22 (19.6%) in the genitourinary tract, 21 (18.8%) in the anorectum, 19 (17.0%) in the esophagus, 10 (8.9%) in the uvea, and 2 (1.8%) in the small bowel. The most significantly mutated genes included BRAF (17%), KIT (15%), RAS (15%), TP53 (13%), NF1 (12%), SF3B1 (11%), GNA11 (7%), GNAQ (5%), and FBXW7 (4%). A large number of chromosomal structural variants was found. The anatomic sites of esophagus and small bowel were independent risk factors for progression-free survival (PFS, hazard ratio [HR] 4.78, 95% confidence interval [CI] 2.42-9.45, P < 0.0001) and overall survival (OS, HR 5.26, 95% CI 2.51-11.03, P < 0.0001). Casitas B-lineage lymphoma (CBL) mutants showed significantly poorer PFS and OS. In contrast, MM patients who received immune checkpoint inhibitors (ICIs) had a significantly more favorable OS (HR 0.39, 95% CI 0.20-0.75, P = 0.008). CONCLUSIONS Our findings reveal the genetic features of patients with MM, mainly across six anatomic sites, offering a potential avenue for targeted therapies.
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Affiliation(s)
- Hai-Yun Wang
- Department of Pathology, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, National Children's Medical Center for South Central Region, 510623, Guangzhou, P. R. China
- Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, National Children's Medical Center for South Central Region, 510623, Guangzhou, P. R. China
| | - Ye Liu
- Shenzhen Hospital, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 518116, Shenzhen, China
- Department of Molecular Diagnostics, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, P. R. China
| | - Ling Deng
- Department of Molecular Diagnostics, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, P. R. China
| | - Kuntai Jiang
- Department of Molecular Diagnostics, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, P. R. China
| | - Xin-Hua Yang
- Department of Molecular Diagnostics, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, P. R. China
| | - Xiao-Yan Wu
- Department of Molecular Diagnostics, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, P. R. China
| | - Kai-Hua Guo
- Department of Anatomy and Neurobiology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan Road, 510080, Guangzhou, P. R. China.
| | - Fang Wang
- Department of Molecular Diagnostics, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, P. R. China.
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12
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Foley CK, Hughes MS, Hehman CT. Malignant primary melanoma of the colon: a case report. J Surg Case Rep 2023; 2023:rjad469. [PMID: 37593186 PMCID: PMC10431205 DOI: 10.1093/jscr/rjad469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 07/30/2023] [Indexed: 08/19/2023] Open
Abstract
Melanoma is most associated with cancer of the skin. However, a small subset of these melanomas can be a primary malignancy of other mucosal membranes. A 55-year-old male presented to the gastroenterologist with 1 year of symptoms typical of colon cancer including bloating, abdominal pain and weight loss. He underwent colonoscopy and a mass was seen in the transverse colon that was later proven melanoma. A PET CT scan showed this was his only focus of disease. He then underwent a laparoscopic-assisted extended right hemicolectomy. He had an uneventful postoperative course. He was thoroughly examined for other sources of melanoma such as cutaneous, anal and uveal sources. He has recovered well at home and is receiving adjuvant pembrolizumab immunotherapy. Mucosal primary melanomas have a worse 5-year survival than primary cutaneous melanomas. A multi-disciplinary approach is necessary to treat and properly diagnose these malignancies.
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Affiliation(s)
| | - Marybeth S Hughes
- Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Charles T Hehman
- Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA
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13
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Ogata D, Nishio S, Hatta N, Kaji T, Fujii K, Mikami M, Kiyohara Y, Enomoto T. Clinicopathological demographics of malignant melanomas of the vulva and vagina in Japan. Melanoma Res 2023; 33:300-308. [PMID: 37162526 PMCID: PMC10309107 DOI: 10.1097/cmr.0000000000000894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/25/2023] [Indexed: 05/11/2023]
Abstract
Malignant vulvar melanoma (VuM) and vaginal melanoma (VaM) represent a unique subgroup of rare malignant melanomas with critical biological properties that differ from other cancers. In Japan, adequate surveys have yet to be conducted. This study aimed to elucidate the clinicopathological demographics and outcomes of VuM and VaM in Japan. This retrospective observational study included women with invasive VuM or VaM identified from older medical records in Japan. We collected clinical data and used the Kaplan-Meier method to analyze progression-free survival (PFS) and overall survival (OS). Univariate and multivariate regression models were used to identify factors significantly related to survival. We identified 217 patients, 109 (50.2%) with VuM and 108 (49.8%) with VaM. The median PFS was 16.8 months in patients with VuM [95% confidence interval (CI), 23.1-87.7] and 15.6 months in those with VaM (95% CI, 8.4-12.6). The median OS was 43.9 months (95% CI, 60-138) and 31.1 months (95% CI, 24.8-45.3) in patients with VuM and VaM, respectively. Multivariate analysis showed that a disease stage higher than stage III, based on the American Joint Committee on Cancer (AJCC) guidelines, was associated with poorer PFS [hazard ratio (HR), 2.063; 95% CI, 0.995-4.278] and an unknown surgical margin was the only independent factor influencing OS (HR, 2.188; 95% CI, 1.203-3.977). The overall outcomes of invasive VuM and VaM in Japan remain poor. AJCC staging and surgical margins were significant predictors of survival.
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Affiliation(s)
- Dai Ogata
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo
| | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka
| | - Naohito Hatta
- Department of Dermatology, Toyama Prefectural Central Hospital, Toyama
| | - Tatsuya Kaji
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kanagawa
| | - Kazuyasu Fujii
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University Hospital, Kanagawa
| | | | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan
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14
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Bennett C, Morgan S, Aboud K, Frazer RD. Use of ctDNA in identifying an actionable BRAF mutation in stage 4 metastatic melanoma. BMJ Case Rep 2023; 16:e254268. [PMID: 37348922 PMCID: PMC10314566 DOI: 10.1136/bcr-2022-254268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
The identification of genetic variants in melanoma has enabled the development of targeted therapies. Under the National Institute for Health and Care Excellence (NICE) guidance, patients with BRAF V600E variant are eligible for BRAF and MEK inhibitor therapy. For those with advanced or highly symptomatic disease, a rapid response to treatment is often seen. Current practice relies on tissue biopsy to perform immunohistochemistry (IHC) or next generation sequencing (NGS) to identify these variants; however, this can take up to 2 weeks. In patients with widespread disease, rapid initiation of treatment can be lifesaving.We describe a case in which hotspot circulating tumour DNA (ctDNA) analysis confirmed BRAF variant 6 days prior to biopsy results. This was utilised to expedite treatment initiation and symptomatically, the patient had initial improvement within a few days.This article demonstrates the potential value of ctDNA analysis and the need for further research into this as an alternative to NGS for patients with rapidly progressive disease.
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Affiliation(s)
| | - Sian Morgan
- Oncology, All Wales Medical Genetics Service, Cardiff, UK
| | - Karam Aboud
- Oncology, Velindre University NHS Trust, Cardiff, UK
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15
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Wan Q, Ren X, Wei R, Yue S, Wang L, Yin H, Tang J, Zhang M, Ma K, Deng YP. Deep learning classification of uveal melanoma based on histopathological images and identification of a novel indicator for prognosis of patients. Biol Proced Online 2023; 25:15. [PMID: 37268878 DOI: 10.1186/s12575-023-00207-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/15/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Deep learning has been extensively used in digital histopathology. The purpose of this study was to test deep learning (DL) algorithms for predicting the vital status of whole-slide image (WSI) of uveal melanoma (UM). METHODS We developed a deep learning model (Google-net) to predict the vital status of UM patients from histopathological images in TCGA-UVM cohort and validated it in an internal cohort. The histopathological DL features extracted from the model and then were applied to classify UM patients into two subtypes. The differences between two subtypes in clinical outcomes, tumor mutation, and microenvironment, and probability of drug therapeutic response were investigated further. RESULTS We observed that the developed DL model can achieve a high accuracy of > = 90% for patches and WSIs prediction. Using 14 histopathological DL features, we successfully classified UM patients into Cluster1 and Cluster2 subtypes. Compared to Cluster2, patients in the Cluster1 subtype have a poor survival outcome, increased expression levels of immune-checkpoint genes, higher immune-infiltration of CD8 + T cell and CD4 + T cells, and more sensitivity to anti-PD-1 therapy. Besides, we established and verified prognostic histopathological DL-signature and gene-signature which outperformed the traditional clinical features. Finally, a well-performed nomogram combining the DL-signature and gene-signature was constructed to predict the mortality of UM patients. CONCLUSIONS Our findings suggest that DL model can accurately predict vital status in UM patents just using histopathological images. We found out two subgroups based on histopathological DL features, which may in favor of immunotherapy and chemotherapy. Finally, a well-performing nomogram that combines DL-signature and gene-signature was constructed to give a more straightforward and reliable prognosis for UM patients in treatment and management.
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Affiliation(s)
- Qi Wan
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Xiang Ren
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Ran Wei
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Shali Yue
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Lixiang Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Hongbo Yin
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Ke Ma
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China.
| | - Ying-Ping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China.
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16
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Du Y, Chang X, Li X, Xing S. Incidence and survival of patients with primary gastrointestinal melanoma: a population-based study. Int J Colorectal Dis 2023; 38:87. [PMID: 36991139 DOI: 10.1007/s00384-023-04385-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Primary gastrointestinal melanoma (PGIM) has received more attention because of its inferior prognosis. Less is known about the incidence and survival rate of PGIM. METHODS PGIM data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The incidence was estimated by age, sex, race, and primary site. Trends in incidence were described as annual percent change (APC). Cancer-specific survival (CSS) and overall survival (OS) rates were estimated and compared using log-rank tests. Cox regression analyses were performed to identify independent prognostic factors. RESULTS The overall incidence of PGIM was 0.360/1,000,000 with a significant upward trend (APC = 1.77%; 95% CI 0.89%-2.67%, p < 0.001) from 1975 to 2016. Most PGIM occurred in the large intestine (0.127/1,000,000) and anorectum (0.182/1,000,000), and both incidences were almost 10 times higher than those of other sites, including the esophagus, stomach, and small intestine. The median survival time was 16 months (IQR, 7-47 months) for CSS and 15 months (IQR, 6-37 months) for OS, and the 3-year CSS and OS rates were 29.5% and 25.4%, respectively. Older age, advanced stage, absence of surgery, and melanoma in the stomach were the independent risk indicators of survival and associated with worse CSS and OS. CONCLUSION The incidence of PGIM has been increasing over the past decades and the prognosis is poor. Thus, further studies are warranted to improve the survival, and more attention should be paid to the patients that are elderly, patients with advanced stage, and patients with melanoma in the stomach.
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Affiliation(s)
- Yu Du
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaona Chang
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiangxiang Li
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shugang Xing
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Mori T, Izumi T, Doi R, Kamimura A, Takai S, Teramoto Y, Nakamura Y. Immune checkpoint inhibitor-based therapy for advanced acral and mucosal melanoma. Exp Dermatol 2023; 32:276-289. [PMID: 36477933 DOI: 10.1111/exd.14725] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
Acral melanoma (AM) and mucosal melanomas (MM) are rare clinical subtypes of melanoma. AM and MM are etiologically, biologically, and molecularly distinct from cutaneous melanoma (CM). Despite the recent development of immune checkpoint inhibitors (ICIs) for the treatment of advanced CMs, the true therapeutic efficacy of ICIs for these rare subtypes remains unclear. Since these subtypes are rare, especially in the Caucasian population, their biological features and corresponding novel therapies are underexplored than those of CM. Even in the larger phase III clinical trials for ICIs, the sample size of patients with AM and MM is limited. Consequently, establishment of standard of care for advanced AM and MM has been challenging. This review covers current update and overview on clinical efficacy of ICIs and ICI-based therapy for advanced AM and MM, based mainly on the reported clinical trials, prospective observational studies, and retrospective studies, to provide a better understanding of the current landscape of this field. In addition, we discuss the future direction of treatment for those rare clinical subtypes, focusing on issues relevant to dermatology and medical oncology.
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Affiliation(s)
- Tatsuhiko Mori
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Teruaki Izumi
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Reiichi Doi
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Anna Kamimura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Sayaka Takai
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yukiko Teramoto
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
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Argyris PP, Naumann J, Jarvis MC, Wilkinson PE, Ho DP, Islam MN, Bhattacharyya I, Gopalakrishnan R, Li F, Koutlas IG, Giubellino A, Harris RS. Primary mucosal melanomas of the head and neck are characterised by overexpression of the DNA mutating enzyme APOBEC3B. Histopathology 2023; 82:608-621. [PMID: 36416305 PMCID: PMC10107945 DOI: 10.1111/his.14843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/12/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022]
Abstract
AIMS Primary head/neck mucosal melanomas (MMs) are rare and exhibit aggressive biologic behaviour and elevated mutational loads. The molecular mechanisms responsible for high genomic instability observed in head/neck MMs remain elusive. The DNA cytosine deaminase APOBEC3B (A3B) constitutes a major endogenous source of mutation in human cancer. A3B-related mutations are identified through C-to-T/-G base substitutions in 5'-TCA/T motifs. Herein, we present immunohistochemical and genomic data supportive of a role for A3B in head/neck MMs. METHODS AND RESULTS A3B protein levels were assessed in oral (n = 13) and sinonasal (n = 13) melanomas, and oral melanocytic nevi (n = 13) by immunohistochemistry using a custom rabbit α-A3B mAb (5210-87-13). Heterogeneous, selective-to-diffuse, nuclear only, A3B immunopositivity was observed in 12 of 13 (92.3%) oral melanomas (H-score range = 9-72, median = 40) and 8 of 13 (62%) sinonasal melanomas (H-score range = 1-110, median = 24). Two cases negative for A3B showed prominent cytoplasmic staining consistent with A3G. A3B protein levels were significantly higher in oral and sinonasal MMs than intraoral melanocytic nevi (P < 0.0001 and P = 0.0022, respectively), which were A3B-negative (H-score range = 1-8, median = 4). A3B levels, however, did not differ significantly between oral and sinonasal tumours (P > 0.99). NGS performed in 10 sinonasal MMs revealed missense NRAS mutations in 50% of the studied cases and one each KIT and HRAS mutations. Publicly available whole-genome sequencing (WGS) data disclosed that the number of C-to-T mutations and APOBEC3 enrichment score were markedly elevated in head/neck MMs (n = 2). CONCLUSION The above data strongly indicate a possible role for the mutagenic enzyme A3B in head/neck melanomagenesis, but not benign melanocytic neoplasms.
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Affiliation(s)
- Prokopios P Argyris
- Department of Biochemistry, Molecular Biology and BiophysicsUniversity of MinnesotaMinneapolisMNUSA
- Masonic Cancer CenterUniversity of MinnesotaMinneapolisMNUSA
- Institute for Molecular VirologyUniversity of MinnesotaMinneapolisMNUSA
- Center for Genome EngineeringUniversity of MinnesotaMinneapolisMNUSA
- Howard Hughes Medical InstituteUniversity of MinnesotaMinneapolisMNUSA
- Division of Oral and Maxillofacial PathologySchool of Dentistry, University of MinnesotaMinneapolisMNUSA
| | - Jordan Naumann
- Department of Biochemistry, Molecular Biology and BiophysicsUniversity of MinnesotaMinneapolisMNUSA
- Masonic Cancer CenterUniversity of MinnesotaMinneapolisMNUSA
- Institute for Molecular VirologyUniversity of MinnesotaMinneapolisMNUSA
- Center for Genome EngineeringUniversity of MinnesotaMinneapolisMNUSA
| | - Matthew C Jarvis
- Department of Biochemistry, Molecular Biology and BiophysicsUniversity of MinnesotaMinneapolisMNUSA
- Masonic Cancer CenterUniversity of MinnesotaMinneapolisMNUSA
- Institute for Molecular VirologyUniversity of MinnesotaMinneapolisMNUSA
- Center for Genome EngineeringUniversity of MinnesotaMinneapolisMNUSA
| | - Peter E Wilkinson
- Department of Diagnostic and Biological SciencesSchool of Dentistry, University of MinnesotaMinneapolisMNUSA
| | - Dan P Ho
- Department of Diagnostic and Biological SciencesSchool of Dentistry, University of MinnesotaMinneapolisMNUSA
| | - Mohammed N Islam
- Department of Oral and Maxillofacial Diagnostic SciencesUniversity of Florida College of DentistryGainesvilleFLUSA
| | - Indraneel Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic SciencesUniversity of Florida College of DentistryGainesvilleFLUSA
| | - Rajaram Gopalakrishnan
- Division of Oral and Maxillofacial PathologySchool of Dentistry, University of MinnesotaMinneapolisMNUSA
| | - Faqian Li
- Department of Laboratory Medicine and PathologyMedical School, University of MinnesotaMinneapolisMNUSA
| | - Ioannis G Koutlas
- Division of Oral and Maxillofacial PathologySchool of Dentistry, University of MinnesotaMinneapolisMNUSA
| | - Alessio Giubellino
- Department of Laboratory Medicine and PathologyMedical School, University of MinnesotaMinneapolisMNUSA
| | - Reuben S Harris
- Department of Biochemistry, Molecular Biology and BiophysicsUniversity of MinnesotaMinneapolisMNUSA
- Masonic Cancer CenterUniversity of MinnesotaMinneapolisMNUSA
- Institute for Molecular VirologyUniversity of MinnesotaMinneapolisMNUSA
- Center for Genome EngineeringUniversity of MinnesotaMinneapolisMNUSA
- Howard Hughes Medical InstituteUniversity of MinnesotaMinneapolisMNUSA
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19
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Mulligan KM, Cullison CR, Zheng DX, Rothermel LD, Levoska MA, Scott JF. Mucosal melanoma and organ-specific metastasis: Differences in survival outcomes between tumor primary sites. J Am Acad Dermatol 2023; 88:678-680. [PMID: 35803400 DOI: 10.1016/j.jaad.2022.06.1198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 06/15/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Kathleen M Mulligan
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
| | - Christopher R Cullison
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - David X Zheng
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Luke D Rothermel
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Melissa A Levoska
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Jeffrey F Scott
- University Hospitals Cleveland Medical Center, Cleveland, Ohio and Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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20
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Romanowska-Dixon B, Dębicka-Kumela M, Śmigielski J, Nowak MS. Sex Differences in the Treatment of Uveal Melanoma in a Group of 1336 Patients. J Pers Med 2023; 13:jpm13020353. [PMID: 36836586 PMCID: PMC9967634 DOI: 10.3390/jpm13020353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023] Open
Abstract
(1) Background: The aim of this study was to analyze the sex differences in the treatment of uveal melanoma (UM) in a group of 1336 patients from a national referral center during the period 2018-2021. (2) Materials and Methods: The study was designed in a retrospective manner. A total of 1336 patients who were newly diagnosed with UM at the Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum, Krakow, Poland, between 1 January 2018 and 31 December 2021, were included in the study. The demographic and clinical data were compiled, including the sex of patients and the treatment methods. (3) Results: In total, 1336 patients with ocular melanoma were identified, including 726 women (54.34%) and 610 men (45.66%). A total of 49.70% of tumors were localized in the right eye and 50.30% in the left eye. UMs were localized statistically significantly more frequently posterior to the equator of the eye globe in men than in women (79.67% vs. 74.10%, Chi^2 Pearson test p = 0.035). Tumors tended to be larger in men, but this difference was not clinically significant. Men were enucleated more often than women (23.44% vs. 18.04%, Chi^2 Pearson test p = 0.015). (4) Conclusions: Statistically significant sex differences were found in the treatment of uveal melanoma in a national referral center in Poland, with men being enucleated more often than women.
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Affiliation(s)
- Bożena Romanowska-Dixon
- Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum, 38 Kopernika Str., 31-501 Krakow, Poland
| | - Magdalena Dębicka-Kumela
- Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum, 38 Kopernika Str., 31-501 Krakow, Poland
| | - Janusz Śmigielski
- Department of Statistics, State University of Applied Science in Konin, 1 Przyjazni Str., 65-510 Konin, Poland
| | - Michał Szymon Nowak
- Institute of Optics and Optometry, University of Social Science, 121 Gdanska Str., 90-519 Lodz, Poland
- Provisus Eye Clinic, 112 Redzinska Str., 42-209 Czestochowa, Poland
- Correspondence: ; Tel.: +48-888-80-10
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21
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An Unusual Case of Primary Gastric Balloon Cell Melanoma. ACG Case Rep J 2023; 10:e00976. [PMID: 36777460 PMCID: PMC9911202 DOI: 10.14309/crj.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/04/2023] [Indexed: 02/14/2023] Open
Abstract
Most cases of melanoma found in the gastrointestinal tract are the result of metastasis. Although uncommon and only described in isolated case reports, primary gastric melanoma should be considered when patients present with vague gastrointestinal symptoms and a mass is identified on esophagogastroduodenoscopy or imaging. We describe a case of primary gastric balloon cell melanoma in a 73-year-old man who presented with melena. Given the high morbidity and mortality of gastric mucosal melanoma, early diagnosis and initiation of treatment can lead to improved outcomes and survival.
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22
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Thawani R, Kim MS, Arastu A, Feng Z, West MT, Taflin NF, Thein KZ, Li R, Geltzeiler M, Lee N, Fuller CD, Grandis JR, Floudas CS, Heinrich MC, Hanna E, Chandra RA. The contemporary management of cancers of the sinonasal tract in adults. CA Cancer J Clin 2023; 73:72-112. [PMID: 35916666 PMCID: PMC9840681 DOI: 10.3322/caac.21752] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 05/21/2022] [Accepted: 06/27/2022] [Indexed: 01/25/2023] Open
Abstract
Sinonasal malignancies make up <5% of all head and neck neoplasms, with an incidence of 0.5-1.0 per 100,000. The outcome of these rare malignancies has been poor, whereas significant progress has been made in the management of other cancers. The objective of the current review was to describe the incidence, causes, presentation, diagnosis, treatment, and recent developments of malignancies of the sinonasal tract. The diagnoses covered in this review included sinonasal undifferentiated carcinoma, sinonasal adenocarcinoma, sinonasal squamous cell carcinoma, and esthesioneuroblastoma, which are exclusive to the sinonasal tract. In addition, the authors covered malignances that are likely to be encountered in the sinonasal tract-primary mucosal melanoma, NUT (nuclear protein of the testis) carcinoma, and extranodal natural killer cell/T-cell lymphoma. For the purpose of keeping this review as concise and focused as possible, sarcomas and malignancies that can be classified as salivary gland neoplasms were excluded.
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Affiliation(s)
- Rajat Thawani
- Division of Hematology and Oncology, Knight Cancer Institute, Oregon Health and Science University
| | - Myung Sun Kim
- Division of Hematology and Oncology, Knight Cancer Institute, Oregon Health and Science University
| | - Asad Arastu
- Department of Internal Medicine, Oregon Health and Science University
| | - Zizhen Feng
- Division of Hematology and Oncology, Knight Cancer Institute, Oregon Health and Science University
| | - Malinda T. West
- Division of Hematology and Oncology, Knight Cancer Institute, Oregon Health and Science University
| | | | - Kyaw Zin Thein
- Division of Hematology and Oncology, Knight Cancer Institute, Oregon Health and Science University
| | - Ryan Li
- Department of Otolaryngology, Division of Head and Neck Surgery, Oregon Health and Science University
| | - Mathew Geltzeiler
- Department of Otolaryngology, Division of Head and Neck Surgery, Oregon Health and Science University
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center
| | | | - Jennifer R. Grandis
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco
| | | | - Michael C. Heinrich
- Division of Hematology and Oncology, Knight Cancer Institute, Oregon Health and Science University
| | - Ehab Hanna
- Department of Head and Neck Surgery, MD Anderson Cancer Center
| | - Ravi A. Chandra
- Department of Radiation Medicine, Oregon Health and Science University
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23
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Deng J, Lin J, Liu C, Li J, Cai J, Zhou X, Li X. N7-methylguanosine methylation-related regulator genes as biological markers in predicting prognosis for melanoma. Sci Rep 2022; 12:21082. [PMID: 36473947 PMCID: PMC9726938 DOI: 10.1038/s41598-022-25698-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
The aim of this study is to find those N7-methylguanosine (m7G) methylation-related regulator genes (m7GMRRGs) which were associated with melanoma prognosis and use them to develop a prognostic prediction model. Clinical information was retrieved online from The Cancer Gene Atlas (TCGA) and the Gene Expression Omnibus (GEO). R software was used to extract m7GMRRGs by differential expression analysis. To create a prognostic risk model, univariate and multivariate Cox regression analyses were employed for the evaluation of the prognostic significance of m7G methylation modifiers. Internal validation using cohort from TCGA (training set) and external validation using cohort from GEO (validation set) of the model were carried out. The model's predictive performance was confirmed by using the Kaplan-Meier, univariate, and multivariate Cox regression, and receiver operating characteristic curve (ROC) by constructing column line plots incorporating clinical factor characteristics. Immune infiltration analyses were performed to assess the immune function of m7GMRRGs. Drug sensitivity analysis was conducted to study chemotherapeutic drug treatment cues. Prognostic models using four m7GMRRGs (EIF4E3, LARP1, NCBP3, and IFIT5) showed good prognostic power in training and validation sets. The area under the curve (AUC) at 1, 3, and 5 years for GEO-melanoma were 0.689, 0.704, and 0.726, respectively. The prediction model could distinctly classify patients with melanoma into different risk subgroups (P < 0.001 for TCGA-melanoma and P < 0.05 for GEO-melanoma). Clinical characteristics were taken into account in Cox regression and AUC analysis, which highlighted that the risk score served as an independent risk factor determining the prognosis of patients with melanoma. Immuno-infiltration analysis showed that m7GMRRGs could potentially regulate CD8+ T cells as well as regulatory T cells (Treg cells). Results of our study indicate a association between m7GMRRGs and melanoma prognosis, and the prognostic prediction model using m7GMRRGs may predict the prognosis of patients with melanoma well. Nevertheless, these results may provide a clue for potential better options of melanoma treatment but need further validation in futural studies.
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Affiliation(s)
- Jiehua Deng
- grid.443385.d0000 0004 1798 9548Department of Plastic and Aesthetic Surgery, The Second Affiliated Hospital of Guilin Medical University, No. 212 Renmin Road, Lingui District, Guilin, 541199 Guangxi Zhuang Autonomous Region China
| | - Jiahua Lin
- grid.488137.10000 0001 2267 2324College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853 China ,Department of Neurosurgery, The 924th Hospital of the Chinese People’s Liberation Army Joint Logistic Support Force, Guilin, 541002 Guangxi Zhuang Autonomous Region China
| | - Chang Liu
- grid.443385.d0000 0004 1798 9548Department of Plastic and Aesthetic Surgery, The Second Affiliated Hospital of Guilin Medical University, No. 212 Renmin Road, Lingui District, Guilin, 541199 Guangxi Zhuang Autonomous Region China
| | - Jiasong Li
- grid.443385.d0000 0004 1798 9548Department of Plastic and Aesthetic Surgery, The Second Affiliated Hospital of Guilin Medical University, No. 212 Renmin Road, Lingui District, Guilin, 541199 Guangxi Zhuang Autonomous Region China
| | - Jun Cai
- grid.443385.d0000 0004 1798 9548Department of Plastic and Aesthetic Surgery, The Second Affiliated Hospital of Guilin Medical University, No. 212 Renmin Road, Lingui District, Guilin, 541199 Guangxi Zhuang Autonomous Region China
| | - Xiyu Zhou
- grid.443385.d0000 0004 1798 9548Department of Plastic and Aesthetic Surgery, The Second Affiliated Hospital of Guilin Medical University, No. 212 Renmin Road, Lingui District, Guilin, 541199 Guangxi Zhuang Autonomous Region China
| | - Xiong Li
- grid.443385.d0000 0004 1798 9548Department of Plastic and Aesthetic Surgery, The Second Affiliated Hospital of Guilin Medical University, No. 212 Renmin Road, Lingui District, Guilin, 541199 Guangxi Zhuang Autonomous Region China
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24
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Muacevic A, Adler JR, Chandra A, Khanal A, Jha N, Kumar A, Phulware RH, Singh A, Durgapal P, Joshi P, Sundriyal D, Kishore S. Primary Malignant Melanoma of the Oral Cavity: A Retrospective Study From a Tertiary Care Centre of North India. Cureus 2022; 14:e32621. [PMID: 36654614 PMCID: PMC9841555 DOI: 10.7759/cureus.32621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mucosal melanoma is a rare but aggressive tumor associated with a poor prognosis arising from pigmented cells called melanocytes. They are usually asymptomatic and present in an advanced stage. It has an aggressive clinical outcome and is proven to be of poor prognosis. MATERIALS AND METHODS This is a retrospective review of the computer database and clinical records at the All India Institute of Medical Sciences, Rishikesh, India. The data between 2018-2022 were reviewed for all small biopsy or excision specimen-proven cases of oral mucosal melanoma. RESULTS The most common site of involvement in the head and neck region is the nasal cavity and paranasal sinuses. In this retrospective study from our institute, all three cases presented involved oral cavities. The median age of presentation was 51 years. Some literature specifies male preponderance. Our patients presented clinically with a black nodule in the oral cavity, which was increasing in size and associated with bleeding. A biopsy performed confirmed the diagnosis of melanoma based on the morphology and immunohistochemical profile of the tumor cells. CONCLUSION Surgical resection is the mainstay treatment, followed by radiation postoperatively to reduce local and regional recurrence. Mucosal melanoma has a poor prognosis, and the majority of patients develop incurable metastatic disease.
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Functional characterization of 5p15.33 risk locus in uveal melanoma reveals rs452384 as a functional variant and NKX2.4 as an allele-specific interactor. Am J Hum Genet 2022; 109:2196-2209. [PMID: 36459980 PMCID: PMC9748249 DOI: 10.1016/j.ajhg.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 11/03/2022] [Indexed: 12/05/2022] Open
Abstract
The TERT/CLPTM1L risk locus on chromosome 5p15.33 is a pleiotropic cancer risk locus in which multiple independent risk alleles have been identified, across well over ten cancer types. We previously conducted a genome-wide association study in uveal melanoma (UM), which uncovered a role for the TERT/CLPTM1L risk locus in this intraocular tumor and identified multiple highly correlated risk alleles. Aiming to unravel the biological mechanisms in UM of this locus, which contains a domain enriched in active chromatin marks and enhancer elements, we demonstrated the allele-specific enhancer activity of this risk region using reporter assays. In UM, we identified the functional variant rs452384, of which the C risk allele is associated with higher gene expression, increased CLPTM1L expression in UM tumors, and a longer telomere length in peripheral blood mononuclear cells. Electrophoretic mobility shift assays and quantitative mass spectrometry identified NKX2.4 as an rs452384-T-specific binding protein, whereas GATA4 preferentially interacted with rs452384-C. Knockdown of NKX2.4 but not GATA4 resulted in increased TERT and CLPTM1L expression. In summary, the UM risk conferred by the 5p locus is at least partly due to rs452384, for which NKX2.4 presents strong differential binding activity and regulates CLPTM1L and TERT expression. Altogether, our work unraveled some of the complex regulatory mechanisms at the 5p15.33 susceptibility region in UM, and this might also shed light on shared mechanisms with other tumor types affected by this susceptibility region.
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Song IH, Sung YE, Kang J, Lee A, Lee SH. Molecular and immunohistochemical comparison between primary gastrointestinal mucosal melanomas and atypical gastrointestinal stromal tumors. Pathol Res Pract 2022; 240:154189. [DOI: 10.1016/j.prp.2022.154189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/19/2022] [Accepted: 10/22/2022] [Indexed: 11/07/2022]
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Stålhammar G. Sex‐based
differences in early and late uveal melanoma‐related mortality. Cancer Med 2022; 12:6700-6710. [PMID: 36398623 PMCID: PMC10067119 DOI: 10.1002/cam4.5458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/28/2022] [Accepted: 11/11/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND It is debated if there are sex-based differences in survival for patients with uveal melanoma. Previous observations of higher mortality for men in studies with <10-year follow-up have not been replicated in studies with longer follow-up. It is therefore hypothesized that women have a worse survival in later periods. METHODS All patients diagnosed with primary uveal melanoma in Sweden between 1980 and 2017 were included (n = 2032). Survival differences between men and women in early (<10 years from diagnosis) and late (≥10 years) periods were analyzed. RESULTS At baseline, there were no significant differences in mean patient age, tumor thickness, diameter, ciliary body involvement, primary treatment modality, or in American Joint Committee on Cancer (AJCC) T-category between men and women. In total, 764 patients (425 women and 339 men) survived and were followed ≥10 years. In this group, men were significantly younger, but there were no differences in baseline tumor thickness, diameter, ciliary body involvement, primary treatment, or AJCC T-category. In competing risk analysis, women had higher incidence of uveal melanoma-related mortality in the late period (p = 0.036). In univariate Cox regression, male (HR 1.2, p = 0.049) and female sex (HR 1.8, p = 0.034) were significant predictors of uveal melanoma-related mortality in the early and late periods, respectively. CONCLUSION Women with uveal melanoma have better survival in the first decade after diagnosis. Thereafter, female survivors are significantly older than men and have a higher incidence of uveal melanoma-related mortality.
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Affiliation(s)
- Gustav Stålhammar
- Division of Eye and Vision, Department of Clinical Neuroscience St. Erik Eye Hospital, Karolinska Institutet Stockholm Sweden
- St. Erik Eye Hospital Stockholm Sweden
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28
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Wang Y, Lian B, Si L, Mao L, Chi Z, Sheng X, Kong Y, Wang X, Bai X, Yan X, Li S, Tang B, Dai J, Zhou L, Wei X, Cui C, Guo J. Cumulative incidence and risk factors of brain metastasis for acral and mucosal melanoma patients with stages I-III. Eur J Cancer 2022; 175:196-203. [PMID: 36137395 DOI: 10.1016/j.ejca.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/12/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Few studies focused on the incidence of brain metastasis in patients with acral and mucosal melanoma, and a better understanding of the incidences and predictors of brain metastasis is needed in these patients. METHOD A prospectively accrued cohort of 799 patients with acral and mucosal melanoma in stages I-III from July 2011 to December 2015 at Peking University Cancer Hospital were included in this study. Competing risk models (Fine and Gray) were used to estimate the cumulative incidence of brain metastasis and compare the differences in cumulative incidence curves between different primary lesions, stages, and molecular types. RESULTS At a median follow-up time of 68.0 months, 60 of the 779 patients (7.7%) developed brain metastasis, and 261 (33.5%) patients developed extracranial metastasis. Considering the risk of competition, the cumulative incidence of brain metastasis at one year, two years, and five years after diagnosis were 5.1%, 10.2%, and 19.5%, respectively. Stage III, BRAF mutations, and NRAS mutations were associated with a high risk of brain metastasis in univariable analysis. Multivariate analysis showed BRAF mutations, and NRAS mutations had statistically correlated with an increased cumulative incidence of brain metastasis at diagnosis and all-time point of one year and two years after diagnosis. CONCLUSION This study is the first to report the cumulative incidence and risk factors of brain metastasis for patients with acral and mucosal melanoma in stages I-III. Patients with BRAF and NRAS mutations had a higher incidence at diagnosis and all-time point, providing the basis for surveillance guidelines and further mechanic exploration.
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Affiliation(s)
- Yang Wang
- Thoracic Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Bin Lian
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lu Si
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - LiLi Mao
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - ZhiHong Chi
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - XiNan Sheng
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yan Kong
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xuan Wang
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xue Bai
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - XieQiao Yan
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - SiMing Li
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - BiXia Tang
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jie Dai
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Li Zhou
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaoting Wei
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - ChuanLiang Cui
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China.
| | - Jun Guo
- Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China.
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Chugh A, Mittal Y, Khatana S, Mishra A, Bhattacharya S, Nigam J. Primary Oral Mucosal Melanoma: A Case Series. J Maxillofac Oral Surg 2022; 21:881-887. [PMID: 36274903 PMCID: PMC9474753 DOI: 10.1007/s12663-021-01537-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/23/2021] [Indexed: 11/26/2022] Open
Abstract
Mucosal melanoma is an exceedingly rare and aggressive neoplasm with high mortality rate. In contrast to the cutaneous melanomas, the risk factors and pathogenesis are poorly understood. It is predominantly localized in the region of the hard palate and maxillary alveolus. Surgery is the mainstay of treatment, but it may turn out to be challenging depending on the anatomic location, extent and size of the tumor and presence of metastasis. Presented here is a series of two cases of maxillary mucosal melanoma with varied presentation.
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Affiliation(s)
- Ankita Chugh
- All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - Yogesh Mittal
- All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - Shruti Khatana
- All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | - Aditi Mishra
- All India Institute of Medical Sciences, Jodhpur, Rajasthan India
| | | | - Jyotsna Nigam
- All India Institute of Medical Sciences, Jodhpur, Rajasthan India
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Characteristics, Treatments, and Survival of Uveal Melanoma: A Comparison between Chinese and American Cohorts. Cancers (Basel) 2022; 14:cancers14163960. [PMID: 36010953 PMCID: PMC9406112 DOI: 10.3390/cancers14163960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/30/2022] [Accepted: 08/10/2022] [Indexed: 11/29/2022] Open
Abstract
Simple Summary This retrospective comparative cohort study aimed to determine whether there were racial or national differences in UM, by comparing the demographic and clinical characteristics, such as tumor size, onset age, trend and proportion of treatment modalities, and overall survival. In the two cohorts, we found that Chinese patients have a younger onset age and a better survival rate. The survival advantage was likely secondary to younger onset age. In addition, a greater proportion of Chinese patients received brachytherapy as opposed to enucleation compared with American patients. This study was the first time comparing patients from different countries and races, which may help ophthalmologists better understand the clinical characteristics of the disease and suggests the importance of early diagnosis and treatment. Abstract Uveal melanoma (UM) is the most common intraocular malignant carcinoma. This study aimed to compare the clinical features, treatment modalities, and prognosis of UM patients in China with those in America over a 15-year period. In the study, 4088 American patients with primary UM from the Surveillance, Epidemiology, and End Results (SEER) database and 1508 Chinese patients from Tongren-ophthalmology Research Association of Clinical Evaluation (TRACE) were included. Univariable and multivariable analyses were performed to determine prognostic factors and propensity score matching (PSM) and sensitivity analyses were applied to adjust for confounders and identify independent prognostic factors. Chinese patients were diagnosed at a younger age (mean ± SD, 47.3 ± 12.5 years vs. 59.7 ± 14.8 years) and tumors at diagnosis were larger (diameter: 12.0 ± 3.54 mm vs. 11.3 ± 8.27 mm; thickness: 7.13 ± 3.28 mm vs. 4.91 ± 3.01 mm). Chinese patients were more likely to undergo brachytherapy than American patients. Chinese patients had better overall survival than American patients while no significant differences exhibited after adjusting for age through PSM. In conclusion, compared with American patients, Chinese patients had younger onset age, larger tumors at diagnosis and better prognosis, mainly because of their younger age.
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Sun H, Zhu N, Gong L, Lan L, Yu Z, Pan Z. Clinicopathological Features, Staging Classification, and Clinical Outcomes of Esophageal Melanoma: Evaluation of a Pooled Case Series. Front Oncol 2022; 12:858145. [PMID: 35847861 PMCID: PMC9283823 DOI: 10.3389/fonc.2022.858145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Studies that have attempted to validate the staging systems and the predictors of survival for patients with primary malignant melanoma of the esophagus (PMME) have been underpowered given their scarcity and small scale. We aimed to review a large number of PMME cases to know more about its clinicopathological features, TNM staging systems, and survival predictors of PMME. Case reports on PMME were extracted from PubMed/Medline through bibliography search and our center. A total of 287 PMME cases were identified. The majority of the patient population was male (72.08%). The most common location of PMME was the lower esophagus (50.62%) and middle esophagus (35.39%). Among the patients, 82.28% received surgical intervention. The median overall survival (OS) duration was 15 months (0.5–244). The American Joint Commission on Cancer staging classification (AJCC) for the mucosal melanoma of the upper aerodigestive tract with stage IVB and IVC integrated in stage IVA showed better distribution of OS than that for esophageal carcinoma. T stage, N stage, and surgery had significant impacts on OS duration in univariate analysis. However, only T stage and N stage were identified as independent factors for OS duration in the multivariate Cox models. PMME is an aggressive tumor with poor prognosis. The AJCC staging system for mucosal melanoma with stage IVB and IVC integrated in stage IVA may be a better option for staging PMME patients. T stage and N stage are independent factors for OS.
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Affiliation(s)
- Haiyan Sun
- Department of Integrative Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin, China
| | - Ningning Zhu
- Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin, China
| | - Lei Gong
- Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin, China
| | - Lan Lan
- Department of Integrative Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin, China
| | - Zhentao Yu
- Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin, China
- *Correspondence: Zhanyu Pan, ; Zhentao Yu,
| | - Zhanyu Pan
- Department of Integrative Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin City, Tianjin, China
- *Correspondence: Zhanyu Pan, ; Zhentao Yu,
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Reggiani HC, Pongeluppi ACA, Ferreira VFMM, Felix IP, de Oliveira Campoli PM. Endoscopic diagnosis of gastric metastases from malignant melanoma: systematic review. Clin Endosc 2022; 55:507-515. [PMID: 35762131 PMCID: PMC9329634 DOI: 10.5946/ce.2022.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/28/2022] [Indexed: 11/14/2022] Open
Abstract
Background/Aims Metastases of malignant melanoma (MM) are rare and associated with poor prognosis. The objective of this study was to analyze the clinical and endoscopic characteristics of gastric metastases of MM by systematically reviewing cases and case series involving patients diagnosed using upper gastrointestinal endoscopy. Methods The PubMed and LILACS databases were searched. Reports containing individual patient data were included. Outcomes such as clinical data, endoscopic findings, treatments, and survival were analyzed.
Results A total of 88 studies with individual data from 113 patients with gastric metastases of MM were included. The primary sites of MM were the skin (62%), eyes (10%), and mucous membranes (6%). Most patients (56%) had multiple metastases in the stomach, located predominantly in the gastric body (approximately 80%). The overall survival rate at 2 years was 4%. There was a significant reduction in the survival of patients with multiple gastric metastases compared to that of patients with single metastasis (hazard ratio, 0.459; 95% confidence interval, 0.235−0.895; p=0.022).
Conclusions Gastric metastases of MM have a poor prognosis, especially in patients with multiple implants in the stomach. Additional studies are needed to verify whether ocular and mucosal melanomas are associated with a higher risk of gastric metastases than that of cutaneous melanomas.
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Saito S, Yasuda M, Araki T, Ida A, Kuriyama Y, Uehara A, Kishi C, Endo Y, Ogawa H, Motegi S. Recurrent advanced rectal malignant melanoma that discontinued anti‐
PD
‐1 antibody after complete response and was refractory to rechallenge. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2022. [DOI: 10.1002/cia2.12264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shintaro Saito
- Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
| | - Masahito Yasuda
- Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
| | - Takeshi Araki
- Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
| | - Azusa Ida
- Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
| | - Yuko Kuriyama
- Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
| | - Akihito Uehara
- Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
| | - Chikako Kishi
- Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
| | - Yukie Endo
- Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
| | - Hiroomi Ogawa
- Department of General Surgical Science Gunma University Graduate School of Medicine Maebashi Japan
| | - Sei‐ichiro Motegi
- Department of Dermatology Gunma University Graduate School of Medicine Maebashi Japan
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Fine GC, Covington MF, Koppula BR, Salem AE, Wiggins RH, Hoffman JM, Morton KA. PET-CT in Clinical Adult Oncology-VI. Primary Cutaneous Cancer, Sarcomas and Neuroendocrine Tumors. Cancers (Basel) 2022; 14:2835. [PMID: 35740501 PMCID: PMC9221374 DOI: 10.3390/cancers14122835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
PET-CT is an advanced imaging modality with many oncologic applications, including staging, therapeutic assessment, restaging and surveillance for recurrence. The goal of this series of six review articles is to provide practical information to providers and imaging professionals regarding the best use of PET-CT for specific oncologic indications, the potential pitfalls and nuances that characterize these applications, and guidelines for image interpretation. Tumor-specific clinical information and representative PET-CT images are provided. The current, sixth article in this series addresses PET-CT in an evaluation of aggressive cutaneous malignancies, sarcomas and neuroendocrine tumors. A discussion of the role of FDG PET for all types of tumors in these categories is beyond the scope of this review. Rather, this article focuses on the most common malignancies in adult patients encountered in clinical practice. It also focuses on Food and Drug Agency (FDA)-approved and clinically available radiopharmaceuticals rather than research tracers or those requiring a local cyclotron. This information will serve as a guide to primary providers for the appropriate role of PET-CT in managing patients with cutaneous malignancies, sarcomas and neuroendocrine tumors. The nuances of PET-CT interpretation as a practical guide for imaging providers, including radiologists, nuclear medicine physicians and their trainees, are also addressed.
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Affiliation(s)
- Gabriel C. Fine
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (G.C.F.); (M.F.C.); (B.R.K.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Matthew F. Covington
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (G.C.F.); (M.F.C.); (B.R.K.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Bhasker R. Koppula
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (G.C.F.); (M.F.C.); (B.R.K.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Ahmed Ebada Salem
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (G.C.F.); (M.F.C.); (B.R.K.); (A.E.S.); (R.H.W.); (J.M.H.)
- Faculty of Medicine, Department of Radiodiagnosis and Intervention, Alexandria University, Alexandria 21526, Egypt
| | - Richard H. Wiggins
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (G.C.F.); (M.F.C.); (B.R.K.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - John M. Hoffman
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (G.C.F.); (M.F.C.); (B.R.K.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Kathryn A. Morton
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (G.C.F.); (M.F.C.); (B.R.K.); (A.E.S.); (R.H.W.); (J.M.H.)
- Intermountain Healthcare Hospitals, Summit Physician Specialists, Murray, UT 84123, USA
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DePalo DK, Elleson KM, Carr MJ, Spiess PE, Zager JS. Genitourinary melanoma: An overview for the clinician. Asian J Urol 2022; 9:407-422. [DOI: 10.1016/j.ajur.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/10/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022] Open
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Loya A, Gombos DS, Patel SP. Second Primary Malignancies in Patients With Melanoma Subtypes: Analysis of 120,299 Patients From the SEER Database (2000-2016). Front Oncol 2022; 12:853076. [PMID: 35372013 PMCID: PMC8972193 DOI: 10.3389/fonc.2022.853076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeEvaluate incidence of second primary malignancies (SPM) after non-acral cutaneous melanoma (NACM), acral lentiginous melanoma (ALM), mucosal melanoma (MM), and uveal melanoma (UM).Patients and MethodsFirst primary NACM, ALM, MM, and UM cases diagnosed 2000-2016 were extracted from SEER. Seer*Stat was used to calculate excess absolute risks (EAR) and standardized incidence ratios (SIR) of SPMs relative to a matched cohort from the general population. P-value of 0.05 determined significance.ResultsInclusion criteria was met by 109,385 patients with NACM, 2166 with ALM, 2498 with MM, and 6250 with UM. Increased incidence of malignancies occurred after NACM (SIR 1.51; 95%CI, 1.49-1.54), ALM (SIR 1.59; 95%CI, 1.40-1.81), MM (SIR 2.14; 95%CI, 1.85-2.45), and UM (SIR 1.24; 95%CI, 1.14-1.34) relative to the general population. Cutaneous melanoma occurred more frequently after NACM (SIR 9.54; 95%CI, 9.27-9.83), ALM (SIR 12.19; 95%CI, 9.70-15.14), MM (SIR 10.05; 95%CI, 7.18-13.68), and UM (SIR 2.91; 95%CI, 2.27-3.66). Patients with initial NACM (SIR 2.44; 95%CI, 1.64-3.51) and UM (SIR 44.34; 95%CI, 29.91-63.29) demonstrated increased incidence of eye and orbit melanoma. Renal malignancies occurred more frequently after NACM (SIR 1.24; 95%CI, 1.11-1.38), MM (SIR 3.54; 95%CI, 1.62-6.72) and UM (SIR 1.68; 95%CI, 1.09-2.48). Increased incidence of thyroid malignancies was observed after NACM (SIR 1.83; 95%CI, 1.61-2.06), ALM (SIR 3.74; 95%CI, 1.71-7.11), MM (SIR 4.40; 95%CI, 1.77-9.06), and UM (SIR 3.79; 95%CI, 2.52-5.47). Increased incidence of lymphoma was observed after NACM (SIR 1.20; 95%CI, 1.09-1.31) and ALM (SIR 2.06; 95%CI, 1.13-3.46).ConclusionPatients with NACM, ALM, MM, and UM have increased incidence of SPMs compared to that expected from the general population. Each of these melanoma subtypes had increased occurrence of cutaneous melanoma and thyroid cancer; some, but not all, had increased occurrence of renal malignancies, eye and orbit melanoma, and lymphoma.
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Affiliation(s)
- Asad Loya
- School of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Dan S. Gombos
- Section of Ophthalmology, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Pediatrics, Division of Cancer Medicine, Baylor College of Medicine, Houston, TX, United States
- Department of Ophthalmology & Visual Sciences, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Sapna P. Patel
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- *Correspondence: Sapna P. Patel,
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Stålhammar G, Herrspiegel C. Long-term relative survival in uveal melanoma: a systematic review and meta-analysis. COMMUNICATIONS MEDICINE 2022; 2:18. [PMID: 35603296 PMCID: PMC9053233 DOI: 10.1038/s43856-022-00082-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/18/2022] [Indexed: 01/22/2023] Open
Abstract
Abstract
Background
A large proportion of patients with uveal melanoma develop metastases and succumb to their disease. Reports on the size of this proportion vary considerably.
Methods
PubMed, Web of Science and Embase were searched for articles published after 1980. Studies with ≥100 patients reporting ≥five-year relative survival rates were included. Studies solely reporting Kaplan-Meier estimates and cumulative incidences were not considered, due to risk for competing risk bias and classification errors. A meta-analysis was performed using random-effects and weighted averages models, as well as a combined estimate based on curve fitting.
Results
Nine studies and a total of 18 495 patients are included. Overall, the risk of selective reporting bias is low. Relative survival rates vary across the population of studies (I2 48 to 97% and Qp < 0.00001 to 0.15), likely due to differences in baseline characteristics and the large number of patients included (τ2 < 0.02). The 30-year relative survival rates follow a cubic curve that is well fitted to data from the random-effects inverse-variance and weighted average models (R2 = 0.95, p = 7.19E−7). The estimated five, ten, 15, 20, 25 and 30-year relative survival rates are 79, 66, 60, 60, 62 and 67%, respectively.
Conclusions
The findings suggest that about two in five of all patients with uveal melanoma ultimately succumb to their disease. This indicates a slightly better prognosis than what is often assumed, and that patients surviving 20 years or longer may have a survival advantage to individuals of the same sex and age from the general population.
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Clinicopathological profile and outcomes of anorectal melanoma from a tertiary care center in India. Future Sci OA 2022; 8:FSO786. [PMID: 35369276 PMCID: PMC8965809 DOI: 10.2144/fsoa-2021-0091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/19/2022] [Indexed: 11/28/2022] Open
Abstract
Background: Anorectal melanoma (AM) is a rare subtype of melanoma. Aim: To study the clinic–pathologic features and outcomes in patients with AM. Materials & methods: Clinical, pathologic findings and outcomes of patients with AM were recorded. Results: Twenty-seven patients with AM were identified with median age of 57 years. Most patients presented in stage III (44.4%). Lymph node involvement was seen in 70.4%. The response to chemotherapy and immunotherapy was 16.6 and 25.0%, respectively. At a median follow up of 11 months, median overall survival was 30 months. Ballantine stage 3 and weight loss at presentation were predictors of poor survival. Conclusion: AM presents at an advanced stage with lymph node and distant metastasis. Anorectal melanoma is a rare subset of melanoma presenting at an advanced stage with lymph node and distant metastasis. Early disease is managed surgically; however, optimal treatment of advanced disease is unclear. The stage at diagnosis is the most important prognostic factor. Prognosis is poor, but with the advent of targeted therapy and immunotherapy, the outcomes are improving.
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Mobuchon L, Derrien AC, Houy A, Verrier T, Pierron G, Cassoux N, Milder M, Deleuze JF, Boland A, Scelo G, Cancel-Tassin G, Cussenot O, Rodrigues M, Noirel J, Machiela MJ, Stern MH. Different Pigmentation Risk Loci for High-Risk Monosomy 3 and Low-Risk Disomy 3 Uveal Melanomas. J Natl Cancer Inst 2022; 114:302-309. [PMID: 34424336 PMCID: PMC8826635 DOI: 10.1093/jnci/djab167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/06/2021] [Accepted: 08/19/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Uveal melanoma (UM), a rare malignant tumor of the eye, is predominantly observed in populations of European ancestry. UMs carrying a monosomy 3 (M3) frequently relapse mainly in the liver, whereas UMs with disomy 3 (D3) are associated with more favorable outcome. Here, we explored the UM genetic predisposition factors in a large genome-wide association study (GWAS) of 1142 European UM patients and 882 healthy controls . METHODS We combined 2 independent datasets (Global Screening Array) with the dataset described in a previously published GWAS in UM (Omni5 array), which were imputed separately and subsequently merged. Patients were stratified according to their chromosome 3 status, and identified UM risk loci were tested for differential association with M3 or D3 subgroups. All statistical tests were 2-sided. RESULTS We recapitulated the previously identified risk locus on chromosome 5 on CLPTM1L (rs421284: odds ratio [OR] =1.58, 95% confidence interval [CI] = 1.35 to 1.86; P = 1.98 × 10-8) and identified 2 additional risk loci involved in eye pigmentation: IRF4 locus on chromosome 6 (rs12203592: OR = 1.76, 95% CI = 1.44 to 2.16; P = 3.55 × 10-8) and HERC2 locus on chromosome 15 (rs12913832: OR= 0.57, 95% CI = 0.48 to 0.67; P = 1.88 × 10-11). The IRF4 rs12203592 single-nucleotide polymorphism was found to be exclusively associated with risk for the D3 UM subtype (ORD3 = 2.73, 95% CI = 1.87 to 3.97; P = 1.78 × 10-7), and the HERC2 rs12913832 single-nucleotide polymorphism was exclusively associated with risk for the M3 UM subtype (ORM3 = 2.43, 95% CI = 1.79 to 3.29; P = 1.13 × 10-8). However, the CLPTM1L risk locus was equally statistically significant in both subgroups. CONCLUSIONS This work identified 2 additional UM risk loci known for their role in pigmentation. Importantly, we demonstrate that UM tumor biology and metastatic potential are influenced by patients' genetic backgrounds.
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Affiliation(s)
- Lenha Mobuchon
- Inserm U830, DNA Repair and Uveal Melanoma (D.R.U.M), Equipe Labellisée par la Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, Paris, France
| | - Anne-Céline Derrien
- Inserm U830, DNA Repair and Uveal Melanoma (D.R.U.M), Equipe Labellisée par la Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, Paris, France
| | - Alexandre Houy
- Inserm U830, DNA Repair and Uveal Melanoma (D.R.U.M), Equipe Labellisée par la Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, Paris, France
| | - Thibault Verrier
- Inserm U830, DNA Repair and Uveal Melanoma (D.R.U.M), Equipe Labellisée par la Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, Paris, France
| | - Gaëlle Pierron
- Somatic Genetic Unit, Department of Genetics, Institut Curie, PSL Research University, Paris, France
| | - Nathalie Cassoux
- Department of Ocular Oncology, Institut Curie, Paris, France
- Faculty of Medicine, University of Paris Descartes, Paris, France
| | - Maud Milder
- Inserm CIC BT 1418, Institut Curie, PSL Research University, Paris, France
| | - Jean-François Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
| | - Ghislaine Scelo
- International Agency for Research on Cancer (IARC), Lyon, France
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Géraldine Cancel-Tassin
- CeRePP, Tenon Hospital, Paris, France
- Sorbonne University, GRC n°5 Predictive Onco-Urology, AP-HP, Tenon Hospital, Paris, France
| | - Olivier Cussenot
- CeRePP, Tenon Hospital, Paris, France
- Sorbonne University, GRC n°5 Predictive Onco-Urology, AP-HP, Tenon Hospital, Paris, France
| | - Manuel Rodrigues
- Inserm U830, DNA Repair and Uveal Melanoma (D.R.U.M), Equipe Labellisée par la Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, Paris, France
- Department of Medical Oncology, Institut Curie, PSL Research University, Paris, France
| | - Josselin Noirel
- Laboratoire GBCM (EA7528), CNAM, HESAM Université, Paris, France
| | - Mitchell J Machiela
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Marc-Henri Stern
- Inserm U830, DNA Repair and Uveal Melanoma (D.R.U.M), Equipe Labellisée par la Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, Paris, France
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Carbó-Bagué A, Rubió-Casadevall J, Puigdemont M, Sanvisens A, Oliveras G, Coll M, del Olmo B, Perez-Bueno F, Marcos-Gragera R. Epidemiology and Molecular Profile of Mucosal Melanoma: A Population-Based Study in Southern Europe. Cancers (Basel) 2022; 14:cancers14030780. [PMID: 35159047 PMCID: PMC8833680 DOI: 10.3390/cancers14030780] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/04/2022] [Accepted: 01/30/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary There are few population-based studies focused on the epidemiology of mucosal melanoma, a rare neoplasm. Its poor prognosis, the different etiology from cutaneous melanoma and the lack of effective treatment beyond corrective surgery, make the knowledge of the mutational profile of this type of cancer a useful tool in understanding its natural history and also for the investigation of new target therapies. The aim of our population-based study is to analyze the incidence and survival of mucosal melanoma, which mainly arises from the head and neck sphere, genitourinary tract and rectal area, and to carry out the mutational analysis of selected cases. We used the Girona Cancer Registry database, which registered all cancer cases in Girona, a province of Spain in southern Europe, during the period of 1994–2018. Abstract Background: Mucosal melanoma is a rare neoplasm on which few epidemiological population-based studies have been published. A good surgical approach is the standard treatment, but the prognosis is worse than that of skin melanoma. The analysis of mucosal melanoma’s mutational profile can help to develop target therapies in advanced disease or adjuvant settings. Methods: We analyzed the database of the Cancer Registry of Girona, a region located in the north-east of Spain, in the period of 1994–2018. We selected cases of primary invasive melanoma, excluding those located in the skin, eye, central nervous system and an unknown primary site. Epidemiological analysis included incidence and survival. Mutational profile analysis was performed with a custom gene panel. Results: Forty-two patients were identified: 14 (33%) had vulvar-vaginal melanoma, 15 (35.7%) had rectal melanoma, 12 (28.6%) had melanoma located in the head and neck sphere and 1 male patient had a urethral melanoma. European age-standardized incidence rates for vulvar-vaginal, rectal and head and neck melanoma were 0.09, 0.1 and 0.09 cases/100,000 inhabitant-years, respectively. Five-year observed survival rates were 37.5%, 20% and 25% for these types of cancers. NRAS Q61 was the most frequent mutation found. Conclusion: Our study confirms the steady incidence and low survival of mucosal melanomas in a region of southern Europe. NRAS and NF1 play a role in the molecular landscape of mucosal melanoma. MEK and PI3K/mTOR inhibitors could be reasonable treatment options and are being studied in clinical trials.
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Affiliation(s)
- Anna Carbó-Bagué
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Josep Trueta, Av. França S/N, 17007 Girona, Spain;
- Research Group on Descriptive Epidemiology, Genetics and Cancer Prevention, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (M.P.); (A.S.); (R.M.-G.)
- Correspondence: ; Tel.: +34-972-225834
| | - Jordi Rubió-Casadevall
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Josep Trueta, Av. França S/N, 17007 Girona, Spain;
- Research Group on Descriptive Epidemiology, Genetics and Cancer Prevention, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (M.P.); (A.S.); (R.M.-G.)
- School of Medicine, University of Girona (UdG), 17003 Girona, Spain;
| | - Montserrat Puigdemont
- Research Group on Descriptive Epidemiology, Genetics and Cancer Prevention, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (M.P.); (A.S.); (R.M.-G.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, 17004 Girona, Spain
| | - Arantza Sanvisens
- Research Group on Descriptive Epidemiology, Genetics and Cancer Prevention, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (M.P.); (A.S.); (R.M.-G.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, 17004 Girona, Spain
| | - Glòria Oliveras
- Pathology Department, Hospital Josep Trueta, Catalan Institute of Health, 17007 Girona, Spain; (G.O.); (F.P.-B.)
| | - Mònica Coll
- Cardiovascular Genetics Center, Biomedical Research Institute of Girona (IDIBGI), 17190 Salt, Spain;
| | - Bernat del Olmo
- School of Medicine, University of Girona (UdG), 17003 Girona, Spain;
- Cardiovascular Genetics Center, Biomedical Research Institute of Girona (IDIBGI), 17190 Salt, Spain;
| | - Ferran Perez-Bueno
- Pathology Department, Hospital Josep Trueta, Catalan Institute of Health, 17007 Girona, Spain; (G.O.); (F.P.-B.)
| | - Rafael Marcos-Gragera
- Research Group on Descriptive Epidemiology, Genetics and Cancer Prevention, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (M.P.); (A.S.); (R.M.-G.)
- School of Medicine, University of Girona (UdG), 17003 Girona, Spain;
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, 17004 Girona, Spain
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Temmermand D, Kilic S, Mikhael M, Butler J, Unsal AA. Sinonasal Mucosal Melanoma: A Population-Based Comparison of the EUROCARE and SEER Registries. Int Arch Otorhinolaryngol 2022; 26:e446-e452. [PMID: 35846812 PMCID: PMC9282965 DOI: 10.1055/s-0041-1740099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/07/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction
Sinonasal melanomas are rare tumors with no comparative survival studies between Europe and the US.
Objective
To provide a population-based survival analysis between the two continents.
Methods
The European Cancer Registry (EUROCARE) and the United States Surveillance, Epidemiology, and End Results (SEER) databases were queried to identify patients diagnosed with sinonasal melanoma between 2000 and 2007. Relative survival (RS) data were grouped by age, gender, geographic region, extent of disease, and treatment modality.
Results
A total of 1,294 cases were identified between 2000 and 2007 (935 from EUROCARE-5 and 359 from SEER). Females were most commonly identified in Europe (56.4%) and in the US (54.9%). Patients over the age of 65 years comprised the greatest proportion of patients in Europe (70%) and in the US (71%). By region, Southern Europe had the highest 5-year RS (31.6%, 95% confidence interval [CI] = [21.3–42.5%]), and Eastern Europe the lowest (16.5%, [7.5–28.5%]). The aggregate European 5-year RS was 25.4% [21.8–29.1%] and the U.S. was (29.7%, [23.6–36%]).
Conclusions
Although increasing in incidence, sinonasal melanomas remain rare. Women were more commonly affected. The most common age group was those older than 65 years, although age did not confer a prognostic value. The most common subsite was the nasal cavity followed by the maxillary sinus. Five-year RS was similar between continents with an inverse relationship between extent of disease and survival. The treatment of choice throughout Europe and the US remains primarily surgical.
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Affiliation(s)
- David Temmermand
- Department of Otolaryngology – Head and Neck Surgery, Augusta University, Augusta, GA, United States
- Department of Otolaryngology & Facial Plastic Surgery, Rowan University School of Osteopathic Medicine, Stratford, NJ, United States
| | - Suat Kilic
- Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Mina Mikhael
- Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Jennifer Butler
- Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Aykut A. Unsal
- Department of Otolaryngology – Head and Neck Surgery, Augusta University, Augusta, GA, United States
- Department of Otolaryngology & Facial Plastic Surgery, Rowan University School of Osteopathic Medicine, Stratford, NJ, United States
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Nanamori H, Sawada Y. Epigenetic Modification of PD-1/PD-L1-Mediated Cancer Immunotherapy against Melanoma. Int J Mol Sci 2022; 23:ijms23031119. [PMID: 35163049 PMCID: PMC8835029 DOI: 10.3390/ijms23031119] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/10/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
Malignant melanoma is one of the representative skin cancers with unfavorable clinical behavior. Immunotherapy is currently used for the treatment, and it dramatically improves clinical outcomes in patients with advanced malignant melanoma. On the other hand, not all these patients can obtain therapeutic efficacy. To overcome this limitation of current immunotherapy, epigenetic modification is a highlighted issue for clinicians. Epigenetic modification is involved in various physiological and pathological conditions in the skin. Recent studies identified that skin cancer, especially malignant melanoma, has advantages in tumor development, indicating that epigenetic manipulation for regulation of gene expression in the tumor can be expected to result in additional therapeutic efficacy during immunotherapy. In this review, we focus on the detailed molecular mechanism of epigenetic modification in immunotherapy, especially anti-PD-1/PD-L1 antibody treatment for malignant melanoma.
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Prouteau A, Mottier S, Primot A, Cadieu E, Bachelot L, Botherel N, Cabillic F, Houel A, Cornevin L, Kergal C, Corre S, Abadie J, Hitte C, Gilot D, Lindblad-Toh K, André C, Derrien T, Hedan B. Canine Oral Melanoma Genomic and Transcriptomic Study Defines Two Molecular Subgroups with Different Therapeutical Targets. Cancers (Basel) 2022; 14:cancers14020276. [PMID: 35053440 PMCID: PMC8774001 DOI: 10.3390/cancers14020276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 02/05/2023] Open
Abstract
Simple Summary In humans, mucosal melanoma (MM) is a rare and aggressive cancer. The canine model is frequently and spontaneously affected by MM, thus facilitating the collection of samples and the study of its genetic bases. Thanks to an integrative genomic and transcriptomic analysis of 32 canine MM samples, we identified two molecular subgroups of MM with a different microenvironment and structural variant (SV) content. We demonstrated that SVs are associated with recurrently amplified regions, and identified new candidate oncogenes (TRPM7, GABPB1, and SPPL2A) for MM. Our findings suggest the existence of two MM molecular subgroups that could benefit from dedicated therapies, such as immune checkpoint inhibitors or targeted therapies, for both human and veterinary medicine. Abstract Mucosal melanoma (MM) is a rare, aggressive clinical cancer. Despite recent advances in genetics and treatment, the prognosis of MM remains poor. Canine MM offers a relevant spontaneous and immunocompetent model to decipher the genetic bases and explore treatments for MM. We performed an integrative genomic and transcriptomic analysis of 32 canine MM samples, which identified two molecular subgroups with a different microenvironment and structural variant (SV) content. The overexpression of genes related to the microenvironment and T-cell response was associated with tumors harboring a lower content of SVs, whereas the overexpression of pigmentation-related pathways and oncogenes, such as TERT, was associated with a high SV burden. Using whole-genome sequencing, we showed that focal amplifications characterized complex chromosomal rearrangements targeting oncogenes, such as MDM2 or CDK4, and a recurrently amplified region on canine chromosome 30. We also demonstrated that the genes TRPM7, GABPB1, and SPPL2A, located in this CFA30 region, play a role in cell proliferation, and thus, may be considered as new candidate oncogenes for human MM. Our findings suggest the existence of two MM molecular subgroups that may benefit from dedicated therapies, such as immune checkpoint inhibitors or targeted therapies, for both human and veterinary medicine.
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Affiliation(s)
- Anais Prouteau
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Stephanie Mottier
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Aline Primot
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Edouard Cadieu
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Laura Bachelot
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Nadine Botherel
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Florian Cabillic
- Laboratoire de Cytogénétique et Biologie Cellulaire, CHU de Rennes, INSERM, INRA, University of Rennes 1, Nutrition Metabolisms and Cancer, 35000 Rennes, France; (F.C.); (L.C.)
| | - Armel Houel
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Laurence Cornevin
- Laboratoire de Cytogénétique et Biologie Cellulaire, CHU de Rennes, INSERM, INRA, University of Rennes 1, Nutrition Metabolisms and Cancer, 35000 Rennes, France; (F.C.); (L.C.)
| | - Camille Kergal
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Sébastien Corre
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Jérôme Abadie
- Laboniris, Department of Biology, Pathology and Food Sciences, Oniris, 44300 Nantes, France;
| | - Christophe Hitte
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - David Gilot
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Kerstin Lindblad-Toh
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA;
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, SE-751 24 Uppsala, Sweden
| | - Catherine André
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
| | - Thomas Derrien
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
- Correspondence: (T.D.); (B.H.); Tel.: +33-2-23-23-43-19 (B.H.)
| | - Benoit Hedan
- IGDR—UMR 6290, CNRS, University of Rennes 1, 35000 Rennes, France; (A.P.); (S.M.); (A.P.); (E.C.); (L.B.); (N.B.); (A.H.); (C.K.); (S.C.); (C.H.); (D.G.); (C.A.)
- Correspondence: (T.D.); (B.H.); Tel.: +33-2-23-23-43-19 (B.H.)
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Shi CJ, Xu SM, Han Y, Zhou R, Zhang ZY. Targeting cyclin-dependent kinase 4/6 as a therapeutic approach for mucosal melanoma. Melanoma Res 2021; 31:495-503. [PMID: 34483306 PMCID: PMC8568331 DOI: 10.1097/cmr.0000000000000777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
Mucosal melanoma is a rare but devastating subtype of melanoma which typically has a worse prognosis than other melanoma subtypes. Large-scale next-generation sequencing studies, including our recent research, have also proved that the molecular landscape and potential oncogenic drivers of mucosal melanoma remain distinct from that of cutaneous melanoma. Recently, a number of selective cyclin-dependent kinase 4 (CDK4)/6 inhibitors have been approved for clinical application in breast cancer or entered phase III clinical trial in other solid tumors. Additionally, we have revealed that the dysregulation of cell cycle progression, caused by CDK4 amplification, is a key genetic feature in half of mucosal melanoma and targeting of CDK4 in selected mucosal melanoma patients is a potentially promising direction for precision cancer treatment by using molecular-characterized mucosal melanoma patient-derived-xenograft models. This review summarizes the current literature regarding CDK4/6 dysregulation in mucosal melanoma, preclinical and clinical studies of CDK4/6 inhibitors and potential combinational strategies in treating mucosal melanoma.
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Affiliation(s)
- Chao-ji Shi
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine
- National Center for Stomatology, National Clinical Research Center for Oral Diseases
| | - Sheng-ming Xu
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine
- National Center for Stomatology, National Clinical Research Center for Oral Diseases
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology
| | - Yong Han
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine
- National Center for Stomatology, National Clinical Research Center for Oral Diseases
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology
| | - Rong Zhou
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine
- National Center for Stomatology, National Clinical Research Center for Oral Diseases
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology
| | - Zhi-yuan Zhang
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine
- National Center for Stomatology, National Clinical Research Center for Oral Diseases
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
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Nakamura Y, Namikawa K, Yoshikawa S, Kiniwa Y, Maekawa T, Yamasaki O, Isei T, Matsushita S, Nomura M, Nakai Y, Fukushima S, Saito S, Takenouchi T, Tanaka R, Kato H, Otsuka A, Matsuya T, Baba N, Nagase K, Inozume T, Fujimoto N, Kuwatsuka Y, Onishi M, Kaneko T, Onuma T, Umeda Y, Ogata D, Takahashi A, Otsuka M, Teramoto Y, Yamazaki N. Anti-PD-1 antibody monotherapy versus anti-PD-1 plus anti-CTLA-4 combination therapy as first-line immunotherapy in unresectable or metastatic mucosal melanoma: a retrospective, multicenter study of 329 Japanese cases (JMAC study). ESMO Open 2021; 6:100325. [PMID: 34839104 PMCID: PMC8633880 DOI: 10.1016/j.esmoop.2021.100325] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/29/2021] [Indexed: 01/14/2023] Open
Abstract
Background Anti-programmed cell death protein 1 (PD-1) antibody monotherapy (PD1) has led to favorable responses in advanced non-acral cutaneous melanoma among Caucasian populations; however, recent studies suggest that this therapy has limited efficacy in mucosal melanoma (MCM). Thus, advanced MCM patients are candidates for PD1 plus anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) combination therapy (PD1 + CTLA4). Data on the efficacy of immunotherapy in MCM, however, are limited. We aimed to compare the efficacies of PD1 and PD1 + CTLA4 in Japanese advanced MCM patients. Patients and methods We retrospectively assessed advanced MCM patients treated with PD1 or PD1 + CTLA4 at 24 Japanese institutions. Patient baseline characteristics, clinical responses (RECIST), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan–Meier analysis, and toxicity was assessed to estimate the efficacy and safety of PD1 and PD1 + CTLA4. Results Altogether, 329 patients with advanced MCM were included in this study. PD1 and PD1 + CTLA4 were used in 263 and 66 patients, respectively. Baseline characteristics were similar between both treatment groups, except for age (median age 71 versus 65 years; P < 0.001). No significant differences were observed between the PD1 and PD1 + CTLA4 groups with respect to objective response rate (26% versus 29%; P = 0.26) or PFS and OS (median PFS 5.9 months versus 6.8 months; P = 0.55, median OS 20.4 months versus 20.1 months; P = 0.55). Cox multivariate survival analysis revealed that PD1 + CTLA4 did not prolong PFS and OS (PFS: hazard ratio 0.83, 95% confidence interval 0.58-1.19, P = 0.30; OS: HR 0.89, 95% confidence interval 0.57-1.38, P = 0.59). The rate of ≥grade 3 immune-related adverse events was higher in the PD1 + CTLA4 group than in the PD1 group (53% versus 17%; P < 0.001). Conclusions First-line PD1 + CTLA4 demonstrated comparable clinical efficacy to PD1 in Japanese MCM patients, but with a higher rate of immune-related adverse events. Anti-PD-1 plus anti-CTLA-4 antibody therapy (PD1 + CTLA4) is an option for patients with advanced mucosal melanoma (MCM). Data on the efficacy of PD1 + CTLA4 compared with PD-1 monotherapy (PD1) for MCM, however, are limited. We retrospectively analyzed data from 329 Japanese patients with advanced MCM treated with PD1 or PD1 + CTLA4. No significant differences in objective response rate, progression-free survival, or overall survival were observed. Immune-related adverse events resulting in treatment cessation were higher in the PD1 + CTLA4 group.
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Affiliation(s)
- Y Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan.
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - S Yoshikawa
- Department of Dermatology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Y Kiniwa
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - T Maekawa
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
| | - O Yamasaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - T Isei
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - S Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - M Nomura
- Department of Clinical Oncology, Kyoto University, Kyoto, Japan
| | - Y Nakai
- Department of Dermatology, Mie University, Tsu, Japan
| | - S Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - S Saito
- Department of Dermatology, Gunma University, Maebashi, Japan
| | - T Takenouchi
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - R Tanaka
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - H Kato
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - A Otsuka
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - T Matsuya
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan
| | - N Baba
- Department of Dermatology, Fukui University, Fukui, Japan
| | - K Nagase
- Division of Dermatology, Department of Internal Medicine, Saga University, Saga, Japan
| | - T Inozume
- Department of Dermatology, Chiba University, Chiba, Japan
| | - N Fujimoto
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Y Kuwatsuka
- Department of Dermatology, Nagasaki University, Nagasaki, Japan
| | - M Onishi
- Department of Dermatology, Iwate Medical University, Morioka, Japan
| | - T Kaneko
- Department of Dermatology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - T Onuma
- Department of Dermatology, Yamanashi University, Kofu, Japan
| | - Y Umeda
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan; Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - D Ogata
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - A Takahashi
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - M Otsuka
- Department of Dermatology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Y Teramoto
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - N Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
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Umeda Y, Yoshikawa S, Kiniwa Y, Maekawa T, Yamasaki O, Isei T, Matsushita S, Nomura M, Nakai Y, Fukushima S, Saito S, Takenouchi T, Tanaka R, Kato H, Otsuka A, Matsuya T, Baba N, Nagase K, Inozume T, Onuma T, Kuwatsuka Y, Fujimoto N, Kaneko T, Onishi M, Namikawa K, Yamazaki N, Nakamura Y. Real-world efficacy of anti-PD-1 antibody or combined anti-PD-1 plus anti-CTLA-4 antibodies, with or without radiotherapy, in advanced mucosal melanoma patients: A retrospective, multicenter study. Eur J Cancer 2021; 157:361-372. [PMID: 34563991 DOI: 10.1016/j.ejca.2021.08.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/05/2021] [Accepted: 08/23/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) have a lower efficacy in mucosal melanoma (MUM) than in cutaneous melanoma. The use of combination treatments with radiotherapy (RT) to improve the efficacy in MUM, however, requires further investigation. METHODS We retrospectively evaluated 225 advanced MUM patients treated with anti-PD-1 monotherapy (PD1; 115) or anti-PD-1 + anti-CTLA-4 combination therapy (PD1+CTLA4; 42) with or without RT (56 and 12, respectively). Treatment efficacy was estimated by determining the objective response rate (ORR) and survival rate with the Kaplan-Meier analysis. RESULTS The baseline characteristics between the two groups in each ICI cohort were similar, except for Eastern Cooperative Oncology Group performance status in the PD1 cohort. No significant differences in ORR, progression-free survival (PFS), and overall survival (OS) were observed between the PD1 alone and PD1+RT groups in the PD1 cohort (ORR 26% versus 27%, P > 0.99; median PFS 6.2 versus 6.8 months, P = 0.63; median OS 19.2 versus 23.1 months, P = 0.70) or between the PD1+CTLA alone and PD1+CTLA4+RT groups in the PD1+CTLA4 cohort (ORR 28% vs 25%, P = 0.62; median PFS 5.8 versus 3.5 months, P = 0.21; median OS 31.7 versus 19.8 months, P = 0.79). Cox multivariate analysis indicated that RT in addition to PD1 or PD1+CTLA4 did not have a positive impact on the PFS or OS. CONCLUSIONS A prolonged survival benefit with RT in combination with ICIs was not identified for advanced MUM patients, although RT may improve local control of the tumour and relieve local symptoms.
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Affiliation(s)
- Yoshiyasu Umeda
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan; Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | | | - Yukiko Kiniwa
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Takeo Maekawa
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
| | - Osamu Yamasaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Taiki Isei
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Shigeto Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Motoo Nomura
- Department of Clinical Oncology, Kyoto University, Kyoto, Japan
| | - Yasuo Nakai
- Department of Dermatology, Mie University, Tsu, Japan
| | - Satoshi Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Shintaro Saito
- Department of Dermatology, Gunma University, Maebashi, Japan
| | | | - Ryo Tanaka
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Hiroshi Kato
- Department of Dermatology, Nagoya City University, Nagoya, Japan
| | - Atsushi Otsuka
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - Taisuke Matsuya
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan
| | - Natsuki Baba
- Department of Dermatology, Fukui University, Fukui, Japan
| | - Kotaro Nagase
- Division of Dermatology, Department of Internal Medicine, Saga University, Saga, Japan
| | | | - Takehiro Onuma
- Department of Dermatology, Yamanashi University, Yamanashi, Japan
| | | | - Noriki Fujimoto
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Takahide Kaneko
- Department of Dermatology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Masazumi Onishi
- Department of Dermatology, Iwate Medical University, Iwate, Japan
| | - Kenjiro Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Naoya Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan.
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Sivasubramaniam P, Tiegs-Heiden CA, Sturgis CD, Hagen CE, Hartley CP, Thangaiah JJ. Malignant gastrointestinal neuroectodermal tumor: Cytologic, histologic, immunohistochemical, and molecular pitfalls. Ann Diagn Pathol 2021; 55:151813. [PMID: 34509898 DOI: 10.1016/j.anndiagpath.2021.151813] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 12/28/2022]
Abstract
Malignant gastrointestinal neuroectodermal tumor (GNET) is a rare malignant primary gastrointestinal mesenchymal tumor which can be diagnosed via fine-needle aspiration (FNA) cytology. In the context of FNA, the diagnosis requires a cell block and the use of significant resources including immunohistochemical stains and molecular testing. The differential diagnosis of GNET includes clear cell sarcoma (CCS), gastrointestinal stromal tumor (GIST), gastric schwannoma, metastatic melanoma, malignant perivascular epithelioid cell tumor (PEComa) and granular cell tumor, among others. Here we describe a case which was initially diagnosed as malignant granular cell tumor by FNA which was later revised to GNET following the finding of an EWSR1-ATF1 fusion gene rearrangement.
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Affiliation(s)
| | | | - Charles D Sturgis
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Catherine E Hagen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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Dalci K, Teke Z, Atar C, Doran F. Primary gastric melanoma presenting with recurrent upper gastrointestinal bleeding. Ann R Coll Surg Engl 2021; 103:e282-e284. [PMID: 34431710 DOI: 10.1308/rcsann.2020.7139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Malignant melanoma of the gastrointestinal tract is usually a metastasis from a cutaneous source. Primary gastric melanoma is an extremely rare clinical entity, with few reported cases worldwide. It is often advanced at the time of diagnosis and is associated with a poor outcome. We report a case of a 57-year-old male who presented to the emergency department with complaints of fatigue, haematemesis and melena. Laboratory investigation indicated a haemoglobin level of 7.4g/dl, for which the patient received a transfusion. Upper gastrointestinal endoscopy revealed a bleeding mass in the body of stomach which provisional histology was suggestive of a malignant mesenchyimal tumour but subsequent cytomorphology and immunophenotyping were consistent with malignant melanoma, with positive S-100, HMB-45 and Melan-A. Dermatological exam indicated two lesions suspicious for the primary site of metastasis but were ultimately diagnosed as benign lesions, one junctional nevus and other one seborrheic keratosis, on biopsies. Ophthalmologic exam showed no other probable sites of origin. PET/CT showed accumulation of tracer in the stomach, jejunum and perigastric lymph nodes. For this reason, primary advanced gastric melanoma was suspected in this patient. Since the patient had recurrent upper gastrointestinal bleeding that required frequent blood transfusion, a total gastrectomy with partial small bowel resection was performed. We report this case to present initial diagnostic challange and discuss performing surgery for recurrent tumour bleeding.
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Affiliation(s)
- K Dalci
- Cukurova University, Adana, Turkey
| | - Z Teke
- Cukurova University, Adana, Turkey
| | - C Atar
- Cukurova University, Adana, Turkey
| | - F Doran
- Cukurova University, Adana, Turkey
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Inamori O, Fukuoka H, Nagamine M, Sotozono C, Konishi E. Mesectodermal Leiomyoma of the Ciliary Body: A Unique Variant of Leiomyoma with Myogenic and Neurogenic Histological Features. Int J Surg Pathol 2021; 30:114-119. [PMID: 34424080 DOI: 10.1177/10668969211038694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mesectodermal leiomyoma of the ciliary body is a rare benign tumor, showing both neurogenic and myogenic characteristics. This tumor typically shows predilection for women of reproductive age. Because it is almost impossible to clinically distinguish this tumor from malignant melanoma, unnecessary eye enucleations have been unfortunately performed. Herein, we report a case of mesectodermal leiomyoma of the ciliary body in a young Japanese woman. She was referred to our hospital due to a slow-growing mass in her left iris. A malignant tumor could not be clinically ruled out and surgery with intraoperative pathology consultation was performed. Intraoperative frozen section diagnosis was a benign tumor with neurogenic features, and a simple excision of the tumor was performed. Histologically, the tumor was composed of diffuse growth of spindle cells with fibrillary indistinctive cytoplasm. Immunohistochemical examination showed diffuse positive staining of α-smooth muscle actin, h-caldesmon, calponin, and CD56. Scattered tumor cells were weakly positive for desmin. Neither melanocytic markers nor neural markers except for CD56 were positive. We diagnosed this tumor as mesectodermal leiomyoma. Mesectodermal leiomyoma is rare and often misdiagnosed as malignant melanoma. To avoid overtreatment, a correct preoperative diagnosis is essential.
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Affiliation(s)
- Osamu Inamori
- 12898Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hideki Fukuoka
- 12898Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Chie Sotozono
- 12898Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eiichi Konishi
- 12898Kyoto Prefectural University of Medicine, Kyoto, Japan
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Abstract
Noncutaneous melanomas are rare subtypes of melanoma with high rates of metastatic disease and poor overall survival. One-third to one-half of cases are amelanotic, which may contribute to a delay in diagnosis. Immunohistochemistry staining with typical melanoma markers helps confirm the diagnosis. There is no standard staging system across mucosal melanomas. Elective nodal dissection is not recommended and there is a paucity of data to support use of sentinel lymph node biopsy. Mutational analysis should be routinely performed. Systemic therapy options include targeted inhibitors, immunotherapy, and cytotoxic chemotherapy, although further studies are needed to confirm their efficacy.
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Affiliation(s)
- Ann Y Lee
- Department of Surgery, NYU Langone Health, 550 1st Avenue, NBV 15N1, New York, NY 10016, USA.
| | - Russell S Berman
- Department of Surgery, NYU Langone Health, 550 1st Avenue, NBV 15N1, New York, NY 10016, USA. https://twitter.com/bermar01
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